Evaluation of the Necessity for Cardioverter-Defibrillator Implantation in Elderly Patients with Brugada Syndrome

Tsukasa Kamakura, Mitsuru Wada, Ikutaro Nakajima, Kohei Ishibashi, Koji Miyamoto, Hideo Okamura, Takashi Noda, Takeshi Aiba, Hiroshi Takaki, Satoshi Yasuda, Hisao Ogawa, Wataru Shimizu, Takeru Makiyama, Takeshi Kimura, Shiro Kamakura, Kengo Kusano

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)

Abstract

Background - The clinical characteristics and prognosis of elderly patients with Brugada syndrome (BrS) are largely unknown. The purpose of this study was to evaluate the risks and benefits of implantable cardioverter defibrillator (ICD) in elderly patients with BrS based on a long follow-up. Methods and Results - A total of 120 BrS patients with ICD (90 for aborted sudden cardiac arrest or syncope, mean age, 46.6±12.2 years; 50 with age ≥60 years at the last follow-up) were included in this study. During 102±68 months of follow-up, 31 patients (26%) experienced appropriate shocks. Age at the first attack of ventricular fibrillation (VF) was <70 years in all patients (mean, 45.0±12.1 years), the incidence of VF decreased with age, and VF did not recur after 70 years of age except in 2 patients with ischemic heart disease. Eleven of 28 patients with supraventricular tachycardia experienced inappropriate shocks. These inappropriate shocks increased with age and reached a peak in patients who were in their sixties. Lead failures occurred in later stages after implantation in 10 of 120 patients (8%). Conclusions - Long-term follow-up of high-risk BrS patients with ICD showed a low incidence of VF in those aged >70 years. Considering the increasing risk of inappropriate shocks because of the relatively late onset of supraventricular tachycardia and lead failures, avoidance of ICD implantation, or replacement may be considered in elderly BrS patients who remain free from VF until 70 years of age.

Original languageEnglish
Pages (from-to)785-791
Number of pages7
JournalCirculation: Arrhythmia and Electrophysiology
Volume8
Issue number4
DOIs
Publication statusPublished - 2015 Aug 22
Externally publishedYes

Keywords

  • Brugada syndrome
  • cardiac
  • death
  • defibrillators
  • implantable
  • myocardial ischemia
  • sudden
  • syncope

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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