Efficacy of Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation in Patients with Brugada-Type Electrocardiogram

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Background: Atrial fibrillation (AF) is often observed in patients with Brugada syndrome, but there are few reports on the efficacy of pulmonary vein isolation (PVI) in these patients. Methods: PVI was performed in 18 consecutive patients (16 men and 2 women) with Brugada-type electrocardiogram (ECG) for paroxysmal AF. Mean age was 57±10 years. Of these 18 patients, 3 were symptomatic and 15 were asymptomatic, 2 showed spontaneous coved-type ECG, 15 showed drug-induced coved-type ECG and 1 showed saddle back-type ECG. The mean follow-up period was 550±345 days. Of the 4 patients with implantable cardioverter-defibrillator, 3 experienced inappropriate shocks because of AF with rapid ventricular response. We compared the electrophysiological conduction properties and clinical course after PVI of these 18 patients with 30 patients with lone AF. Results: No significant differences in age, number of sessions, and PVI strategy were observed in both groups. No significant differences in intra-atrial conduction time and effective refractory period of each pulmonary vein were observed in both groups. AF-free survival rate post-PVI was comparably good in both groups (89% vs. 87%, p=ns). Conclusion: Thus, PVI for paroxysmal AF in patients with Brugada-type ECG is as effective as in patients with lone AF.