Cohort study
Long-Term Outcomes of Brugada Substrate Ablation: A Report from BRAVO (Brugada Ablation of Ventricular Fibrillation (VF) Substrate Ongoing Multicenter Registry)
- Multicentre international registry study
Authors' conclusion
Ablation treatment is safe and highly effective in preventing VF recurrence in high-risk BrS.
Study context
- Population
- High-risk symptomatic Brugada syndrome with spontaneous VF, undergoing epicardial substrate ablation
- Participants
- 159 participants
- Outcome
- Freedom from VF recurrence
- Follow-up
- Mean 48±29 months from last ablation
Main finding
As reported in the abstract
Free of VF after a single procedure
128 of 159 (81%)
Free of VF after repeated procedure (mean 1.2±0.5 procedures; median=1)
153 (96%)
Kaplan-Meier VF-free survival beyond 5 years after last ablation
95%
Observational data: associations, not effects.
Further findings
Predictor of VF-free outcome (multivariable): normalization of type 1 Brugada ECG after ablation
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| Normalization of type 1 Brugada ECG · with and without sodium-channel blockade | 0.078 (0.008–0.753) | P = 0.0274 | |
| 0.050.21520Hazard ratio (log scale) |
VF burden and frequency of shocks
- Before ablation
- 1.1±2.1 per month
- After last ablation
- 0.003±0.14 per month
- P<0.0001
Location of VF/Brugada syndrome (BrS) substrate
- Epicardial RV outflow tract
- all patients
- Also inferior RV epicardium
- 45 (29%)
- Posterior LV epicardium
- 3
Arrhythmic or cardiac deaths
- Arrhythmic or cardiac deaths
- 0
Safety
Hemopericardium
- Hemopericardium
- 4 (2.5%)
Original publication
Long-Term Outcomes of Brugada Substrate Ablation: A Report from BRAVO (Brugada Ablation of VF Substrate Ongoing Multicenter Registry). Circulation. Published 24 March 2023. doi:10.1161/circulationaha.122.063367
Summarised from the published abstract; every number is checked against it