Efficacy of Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation Patients With a Brugada Electrocardiogram

Yamada, Takumi; Yoshida, Yukihiko; Tsuboi, Nobuyuki; Murakami, Yoshimasa; Okada, Taro; McElderry, H. Thomas; Yoshida, Naoki; Doppalapudi, Harish; Epstein, Andrew E.; Plumb, Vance J.; Inden, Yasuya; Murohara, Toyoaki; Kay, G. Neal

doi:10.1253/circj.72.281

Cited by 25 publications

(17 citation statements)

References 13 publications

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“…As the pharmacological management of AF may be challenging, catheter ablation may be an attractive choice of treatment 70,71 . The role of pulmonary vein (PV) isolation remains unclear due to our lack of knowledge of AF mechanisms in the BrS population.…”

Section: Long‐term Management and Prognosismentioning

confidence: 99%

“…The role of pulmonary vein (PV) isolation remains unclear due to our lack of knowledge of AF mechanisms in the BrS population. Yamada et al 71 published a case series of six patients and reported freedom from AF after catheter ablation in 83% of patients (5/6) at 1‐year follow‐up; of interest, they noted a lack of pulmonary vein ectopics, raising the possibility that AF triggers could originate from elsewhere in the atria. Conte et al 70 analyzed the outcome of PV isolation using cryoablation or radiofrequency energy ablation in patients with BrS with recurrent episodes of AF and reported 67% freedom of atrial arrhythmias without AADs in a 2‐year follow‐up; moreover, inappropriate ICD interventions for atrial arrhythmias were completely eliminated.…”

Section: Long‐term Management and Prognosismentioning

confidence: 99%

“…21,22 As the pharmacological management of AF may be challenging, catheter ablation may be an attractive choice of treatment. 70,71 The symptomatic BrS experienced inappropriate shocks, not only due to supraventricular arrhythmias but also due to lead fracture and T-wave oversensing. No significant differences were found in terms of inappropriate shock rates between patients implanted with transvenous ICD and those implanted with an epicardial system.…”

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confidence: 99%

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Atrial fibrillation in Brugada syndrome: Current perspectives

Vlachos

Mascia

Martin

et al. 2020

Cardiovasc electrophysiol

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The incidence of atrial fibrillation (AF) in Brugada syndrome (BrS) has been reported at between 9% and 53% by different series, but the true prevalence is unknown. However, AF may be the presenting feature in some patients. The underlying mechanisms for AF may be a combination of multiple factors, genetic or acquired, that may impact upon autonomic function, atrial structure, and conduction velocities or other unknown factors. The presence of AF has been associated with a more malignant course, with a greater incidence of syncope and ventricular arrhythmias, thus acting as marker of more advanced disease. Regarding the management of patients with AF, antiarrhythmic drugs effective in preventing malignant arrhythmias in BrS such as quinidine or invasive treatment with pulmonary vein isolation (PVI) may be useful in AF treatment. In this review, we aim to present the current perspectives regarding the genetics, pathophysiology, management, and prognosis of AF in patients with BrS.

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Section: Long‐term Management and Prognosismentioning

confidence: 99%

Section: Long‐term Management and Prognosismentioning

confidence: 99%

mentioning

confidence: 99%

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Atrial fibrillation in Brugada syndrome: Current perspectives

Vlachos

Mascia

Martin

et al. 2020

Cardiovasc electrophysiol

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“…Despite this, a few investigators have reported case series in small groups of patients with short-term follow-up (<1 year) that have improved rates of reported, symptomatic recurrences of AF. 31 ICD implantation is indicated in patients at high risk for SCD in Brugada for primary and secondary prevention. ICD therapies, whether or not they are appropriate, have been shown to reduce quality of life by generating anxiety, depression, and isolating social behavior.…”

Section: Managementmentioning

confidence: 99%

Atrial Fibrillation and Brugada Syndrome

Kim

Huffer

2012

Cardiac Electrophysiology Clinics

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“…Similar changes occur in the atria and could be the substrate for re-entrant atrial tachyarrhythmias. 6) Atrial arrhythmias are being recognized with increasing frequency in patients with Brugada syndrome. Incidences of spontaneous atrial arrhythmias between 0% and 53% have been reported, [7][8][9][10][11][12][13][14][15][16][17][18] although the inducibility of atrial arrhythmia ranges from 3% to 100%.…”

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confidence: 99%

Abnormal Atrial Repolarization and Depolarization Contribute to the Inducibility of Atrial Fibrillation in Brugada Syndrome

et al. 2010

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SummaryBrugada syndrome is often accompanied by atrial tachyarrhythmia, such as atrial fibrillation (AF). The aim of this study was to examine atrial vulnerability in patients with Brugada syndrome. Two groups of patients were compared: 18 patients with Brugada syndrome (Brugada syndrome group) and 11 age-matched patients with neither organic heart disease nor AF episodes (control group). Programmed electrical stimulation was performed from the right atrium (RA), and the effective refractory period of the right atrium (ERP-RA), interatrial conduction time (IACT), monophasic action potentials (MAPs) at the high RA, and the inducibility of AF lasting > 30 seconds were studied. MAP duration at 80% repolarization (MAPD 80 ) was calculated. AF was induced with a single extrastimulus or double extrastimuli in all patients with Brugada syndrome but in none of the control patients. The ERP-RA did not differ between the groups. IACT at the shortest diastolic interval was significantly increased in the Brugada syndrome group compared to that in the control group. The maximum slope of the MAPD 80 restitution curve was significantly steeper in the Brugada syndrome group than in the control group (2.4 ± 2.0 versus 0.82 ± 0.36, P < 0.02). Ventricular fibrillation was induced with ventricular programmed stimulation in all Brugada syndrome patients. Both abnormal interatrial conduction and steep restitution of action potential duration may contribute to the atrial arrhythmogenicity in Brugada syndrome. (Int Heart J 2010; 51: 159-165)

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Efficacy of Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation Patients With a Brugada Electrocardiogram

Cited by 25 publications

References 13 publications

Atrial fibrillation in Brugada syndrome: Current perspectives

Atrial fibrillation in Brugada syndrome: Current perspectives

Atrial Fibrillation and Brugada Syndrome

Abnormal Atrial Repolarization and Depolarization Contribute to the Inducibility of Atrial Fibrillation in Brugada Syndrome

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