Impact of electrocardiogram screening during drug challenge test for the prediction of T-wave oversensing by a subcutaneous implantable cardioverter defibrillator in patients with Brugada syndrome

Tsukasa Kamakura, Mitsuru Wada, Kohei Ishibashi, Yuko Y. Inoue, Koji Miyamoto, Hideo Okamura, Satoshi Nagase, Takashi Noda, Takeshi Aiba, Satoshi Yasuda, Kengo Kusano

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Screening tests conducted at rest may be inadequate for the prediction of the T-wave oversensing (TWOS) in subcutaneous implantable cardioverter defibrillator (S-ICD) candidates with Brugada syndrome (BrS) because of the dynamic nature of electrocardiogram (ECG) morphology. We evaluated the utility of ECG screening during drug challenge (DC) for prediction of TWOS in BrS patients implanted with an S-ICD. The study enrolled 6 consecutive BrS patients implanted with an S-ICD. In addition to baseline ECG screening, pre-implant screening during DC using a sodium channel blocker was performed in all patients. All patients underwent appropriate morphological analysis on baseline ECG screening; however, 2 BrS patients (33%) showed inappropriate sensing during DC. During 243 days of follow-up after S-ICD implantation, no patient experienced an appropriate shock. TWOS was confirmed during exercise testing in one of 2 patients who showed inappropriate sensing during DC. However, one patient with appropriate sensing during DC experienced recurrent episodes of inappropriate shocks due to TWOS during exercise. The present initial experience indicates that further studies are needed to detect the risk for TWOS from an S-ICD in BrS patients.

Original languageEnglish
Pages (from-to)1277-1283
Number of pages7
JournalHeart and Vessels
Volume32
Issue number10
DOIs
Publication statusPublished - 2017 Oct 1
Externally publishedYes

Keywords

  • Brugada syndrome
  • Drug challenge test
  • Subcutaneous implantable cardioverter defibrillator
  • T-wave oversensing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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