Brugada syndrome is an inherited arrhythmogenic disease, characterized by coved-type
ST-segment elevation in right precordial electrocardiographic (ECG) leads and an increased
risk of sudden cardiac death due to ventricular fibrillation (VF). The catastrophic
event of sudden cardiac death can be prevented by an implantable cardioverter-defibrillator
(ICD), but a traditional endocardial ICD has been associated with higher complication
rates in patients with Brugada syndrome than in the general population with ICD. The
subcutaneous ICD (S-ICD; Boston Scientific Inc, Natick, MA) does not require endocardial
leads and can provide clinical advantages in these patients. However, a concern with
an S-ICD is the paucity of data about shock efficacy for the termination of spontaneous
tachyarrhythmias. Especially in patients with Brugada syndrome, the potential risk
of tachyarrhythmias undersensing exists owing to their manifestation in the form of
polymorphic ventricular tachycardia (VT) or low-amplitude-wave VF.
Abbreviations:
ECG (electrocardiogram/electrocardiographic), ICD (implantable cardioverter-defibrillator), S-ICD (subcutaneous implantable cardioverter-defibrillator), VF (ventricular fibrillation), VT (ventricular tachycardia)Keywords
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Article info
Publication history
Published online: August 12, 2013
Footnotes
Dr Cappato has intellectual properties and equities in Cameron Health Inc, the manufacturer that produces the subcutaneous implantable cardioverter-defibrillator technology.
Identification
Copyright
© 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
