Brugada症候群に対する植込み型除細動器治療の長期予後

概要

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Brugada syndrome (BS) is an arrhythmogenic disease characterized by an ECG pattern of ST-segment elevation in the right precordial leads and an increased risk of sudden cardiac death as a result of ventricular fibrillation. The aim of this study was to evaluate the long-term prognosis of implantable cardioverter-defibrillator therapy in patients with BS. A total of 44 individuals with typical Brugada ECG pattern were implanted with defibrillators in our institute from 1990 to 2007. Of these, 17 (39%) had to be resuscitated because of cardiac arrest 18 (41%) had syncope of unknown origin, and 9 (19%) were asymptomatic. During a mean follow-up of 83 ± 53 months, 10 of the 17 (59%) with cardiac arrest and 8 of 18 (44%) with prior syncope had an appropriate shock, whereas only 1 of 9 asymptomatic patients (11%) had an arrhythmic event. Complications occurred in 34% of the patients, including inappropriate shocks in 13 patients. The reasons for inappropriate therapy were atrial fibrillation (7), lead fracture (3), sinus tachycardia (2) and T-wave oversensing (1). The incidence of complication among the three groups wasn't statistically different. Asymptomatic BS patients have a similar occurrence of complications however a relatively low incidence of appropriate therapy.
東京女子医科大学の論文