Surface Electrocardiogram Screening for Subcutaneous Implantable Cardioverter-Defibrillators in Japanese Patients With and Without Brugada Syndrome.

Abstract

BACKGROUND:

Subcutaneous implantable cardioverter-defibrillators (S-ICD) could eliminate lead-associated complications. We assessed the prevalence of S-ICD ineligibility in conventional ICD recipients and compared it in patients with and without Brugada syndrome (BrS).Methods and Results:Consecutive patients with a transvenous ICD without an indication for antibradycardia pacing were assessed. A patient was considered eligible for S-ICD if the ECG satisfied the screening template, both supine and standing, in ≥1 lead. Among 130 patients (103 men, age 57±15 years), a total of 18 (13.8%) patients were ineligible. The BrS group (n=33) had a significantly higher prevalence of S-ICD screening failure as compared with the non-BrS group (P=0.003; 30% vs. 8.2%). In the BrS group, the body mass index (BMI) was significantly lower, and T/QRS amplitude in lead I was significantly higher in those who were ineligible than that in the patients who were eligible. Of the 10 BrS patients failing the screening, 4 became eligible in the right parasternal electrode position.

CONCLUSIONS:

Among current ICD patients, there was a high incidence of patients with BrS who were unsuitable for S-ICD based on the left parasternal screening test. Suitability screening of patients for S-ICDs should be conducted carefully in patients with BrS, particularly if the BMI is low. Right parasternal electrode positioning should also be tested in such BrS patients.

• Authors: Mihoko Kawabata, Masahiko Goya, Takeshi Sasaki, Shingo Maeda, Atsuhiko Yagishita, Yasuhiro Shirai, Masakazu Kaneko, Shinya Shiohira, Mitsuaki Isobe, Kenzo Hirao
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 81 Issue 7 Pg. 981-987 (Jun 23 2017) ISSN: 1347-4820 [Electronic] Japan
• PMID: 28367844 (Publication Type: Clinical Trial, Comparative Study, Journal Article)

Topics

• Adult
• Aged
• Asian People
• Body Mass Index
• Brugada Syndrome (epidemiology, physiopathology, therapy)
• Defibrillators, Implantable
• Electrocardiography (methods)
• Female
• Humans
• Japan
• Male
• Middle Aged
• Prevalence