Programmed electrical stimulation in Brugada syndrome: How reproducible are the results?

Maurizio Gasparini, Silvia G. Priori, Massimo Mantica, Fernando Coltorti, Carlo Napolitano, Paola Galimberti, Raffaella Bloise, Carlo Ceriotti

Research output: Contribution to journalArticlepeer-review

Abstract

PES in Brugada Syndrome. Introduction: Inducibility of ventricular arrhythmias at programmed electrical stimulation (PES) ranges between 50% and 80% of patients with Brugada syndrome. However, the variety of PES protocols and the lack of data relative to a control group or to ventricular arrhythmia reproducibility contribute to a still undefined interpretation of PES outcome in Brugada syndrome. Methods and Results: Twenty-one patients with Brugada syndrome (18 men and 3 women; mean age 34 years; 9/21 symptomatic; 8/21 with SCNSA gene mutation) underwent a PES protocol from two right ventricular sites. The endpoint was PES protocol completion or induction of sustained or reproducible (> 6 consecutive inductions) nonsustained (> 6 beats) fast ventricular arrhythmia. In 17 of 21 patients with Brugada syndrome, PES was repeated 2 months later to test ventricular arrhythmia reproducibility. Twenty-five healthy patients (17 men; mean age 36 years) formed the control group. In patients with Brugada syndrome, ventricular arrhythmia inducibility rate at PES was high (18/21 patients [85%]) and increased with protocol aggressiveness, independent of clinical presentation. In control subjects, no ventricular arrhythmias were induced. Among patients with Brugada syndrome, 14 (82%) of 17 patients remained inducible at a second PES. Conclusion: In our experience, ventricular arrhythmia inducibility in patients with Brugada syndrome, at variance with healthy controls, is high and does not correlate with clinical presentation. PES inducibility is deeply influenced by the protocol used. PES outcome is reproducible at a mid-term follow-up mainly if a categorical endpoint (inducible vs noninducible) is used. The need to assess the predictive value of specific PES protocols in targeted studies is widely emerging and is confirmed by our results.

Original languageEnglish
Pages (from-to)880-887
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume13
Issue number9
Publication statusPublished - Sep 1 2002

Keywords

  • Electrophysiologic study
  • Risk factors
  • Sudden death
  • Syncope

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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