Arrhythmias & electrophysiology
Subcutaneous Implantable Defibrillator Therapy in Patients With Brugada Syndrome: Data From a Large Multicenter Registry
Authors' conclusion
Our findings support the S-ICD as a viable alternative to the transvenous ICD for preventing sudden cardiac death in BrS patients without pacing indication (Arrhythmias Detection in a Real World Population [RHYTHM DETECT]; NCT02275637).
Study context
- Population
- Patients with Brugada syndrome who underwent subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation between 2014 and 2024consecutive Brugada syndrome (BrS) patients (mean age 43 ± 12, 86% male)
- Participants
- 450 patients
- Outcome
- Appropriate shocks
- Follow-up
- Median 52 months (25th-75th percentile: 29-72)
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Appropriate shocks, % of patients
3%
Appropriate shocks at 12 months
1.2%; 95% CI: 0.2-2.2
First-shock success rate
90%
Success rate with 2 shocks
100%
Further findings
Inappropriate shocks · median follow-up of 52 months
- Inappropriate shocks, % of patients
- 7%
- Inappropriate shocks at 12 months
- 1.4%; 95% CI: 0.3-2.5
Independent protective factors against inappropriate shock
- Shock zone programmed at 250 beats/min
- HR: 0.40; 95% CI: 0.18-0.89; P = 0.025
- More than 1 suitable vector on screening
- HR: 0.39; 95% CI: 0.17-0.87; P = 0.023
Safety
Device-related complications
- Device-related complications, % of patients
- 4%
- Device-related complications at 12 months
- 2.5%; 95% CI: 1.0-3.9
Need for antibradycardia pacing
- Patients needing antibradycardia pacing
- 3 patients (0.7%)
- 3 patients (0.7%)
Original publication
Subcutaneous Implantable Defibrillator Therapy in Patients With Brugada Syndrome: Data From a Large Multicenter Registry. JACC Clin Electrophysiol. Published 29 March 2025. doi:10.
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