Ventricular tachycardia, fibrillation inducibility not predictive of cardiac events in Brugada syndrome

Issue: June 2011

Heart Rhythm Society 32nd Annual Scientific Sessions

Results from the PRELUDE registry have shown that ventricular tachycardia and ventricular fibrillation inducibility was not associated with an increased risk of cardiac events among individuals with Brugada syndrome. However, a spontaneous Type I electrocardiogram and history of syncope were predictive of events.

“Our results do not confirm previous results of the predictive role of electrical stimulation in Brugada Syndrome,” Carlo Napolitano, MD, PhD, research associate professor, New York University School of Medicine, N.Y., and study investigator, said in a press conference. “But we identified novel risk stratification tools that might be useful to identify the patient at risk for sudden death and to decide which patient deserves an ICD.”

The study was conducted by Napolitano and fellow researchers from Italy and New York institutions who analyzed patients from 42 electrophysiology centers in Italy enrolled in the PRELUDE registry. All 308 consecutive patients (median age, 44 years; 80% men) had a type I ECG either at baseline or after pharmacologic challenge, and did not have a history or cardiac arrest.

Over the median follow-up of 34 months, 14 events occurred, of which 13 patients received appropriate shocks. According to data, 40% of patients had ventricular tachyarrhythmia induced from programmed electrical stimulation, which at follow-up was not a predictor of arrhythmic events.

What did prove to predict events, however, was a history of syncope and spontaneous type I ECG (HR=4.20). Additional independent predictors included QRS fragmentation (HR=4.94) and ventricular refractory period less than 200 ms (HR=3.91). – by Brian Ellis

For more information:

Verma A. LB-03. Presented at: Heart Rhythm Society 32nd Annual Scientific Sessions; May 4-7, 2011; San Francisco.

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