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Shock efficacy of the entirely subcutaneous defibrillator for termination of spontaneous ventricular fibrillation in Brugada syndrome

Published:August 12, 2013DOI:https://doi.org/10.1016/j.hrthm.2013.08.008
      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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