Near Fatal Electrical Storm in a Patient Equipped with an Implantable Cardioverter Defibrillator for Brugada Syndrome

Chalvidan, Thierry; Deharo, Jean‐Claude; Dieuzaide, Pierre; Defaye, Pascal; Djiane, P

doi:10.1111/j.1540-8159.2000.tb06772.x

Cited by 30 publications

(8 citation statements)

References 7 publications

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“…2,8 -11 The high mortality rate in patients suffering from ES might be related to progressive deterioration of cardiac function resulting from the direct cell injury effect caused by frequent shocks 33,34 ; additionally, prolonged exposure to low-output states may further compromise cardiac contractility and impair renal and hepatic function. 35 In our population, a direct effect of CA on the prevention of ES has been suggested by the evidence that ES recurred only in the case of acute failure of the procedure; on other hand, survival rates were significantly higher among patients who had undergone CA successfully. Therefore, the favorable impact on CD may be related in part to the prevention of ES; in fact, 4 of 8 patients with ES recurrence died because of the recurrent event, whereas the 4 survivors required an immediate surgical treatment.…”

Section: Impact On Overall Prognosismentioning

confidence: 97%

Catheter Ablation for the Treatment of Electrical Storm in Patients With Implantable Cardioverter-Defibrillators

et al. 2008

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Background-Electrical storm (ES) caused by recurrent episodes of ventricular tachycardia (VT) can cause sudden death in patients with implantable cardioverter-defibrillators and adversely affects prognosis in survivors. Catheter ablation has been proposed for treating ES, but its long-term effect in a large population has never been verified. Methods and Results-Ninety-five consecutive patients with coronary artery disease (72 patients), idiopathic dilated cardiomyopathy (10 patients), and arrhythmogenic right ventricular dysplasia/cardiomyopathy (13 patients) undergoing catheter ablation for drug-refractory ES were prospectively evaluated. Short-term efficacy was defined by a complete protocol of programmed electric stimulation and by in-hospital outcome; long-term analysis addressed ES recurrence, cardiac mortality, and VT recurrence. Pleomorphic/nontolerated VTs required electroanatomic and noncontact mapping in 48 and 22 patients, respectively, and percutaneous cardiopulmonary support in 10 patients. An epicardial approach was used in 10 patients. After 1 to 3 procedures, induction of any clinical VT(s) by programmed electrical stimulation was prevented in 85 patients (89%). ES was acutely suppressed in all patients; a minimum period of 7 days with stable rhythm was required before hospital discharge. At a median follow-up of 22 months (range, 1 to 43 months), 87 patients (92%) were free of ES and 63 patients (66%) were free of VT recurrence. Eight of 10 patients with persistent inducibility of clinical VT(s) had ES recurrence; 4 of them died suddenly despite appropriate implantable cardioverter-defibrillator intervention. All together, 11 of 95 patients (12%) died of cardiac-related reasons. In the group of patients presenting with all clinical VTs acutely abolished, no ES recurrence was documented, and cardiac mortality was significantly lower compared with the group of patients showing Ն1 clinical VT still inducible after catheter ablation. Conclusions-Advanced strategies of catheter ablation applied to a large population of patients are effective in the short-term treatment of ES. By preventing ES recurrence, catheter ablation may play a protective role over the long term and, together with long-term pharmacological therapy, may favorably affect cardiac mortality. (Circulation. 2008;117: 462-469.)

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Section: Impact On Overall Prognosismentioning

confidence: 97%

Catheter Ablation for the Treatment of Electrical Storm in Patients With Implantable Cardioverter-Defibrillators

et al. 2008

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“…Actually, the authors are not aware of a single case of death occurring in a patient with the Brugada syndrome treated with an ICD. Chalvidan et al 11 reported a case of near-fatal electrical storm in a patient with an ICD, but the patient subsequently fully recovered. In addition, there is no doubt that most patients who have experienced the trauma of cardiac arrest will feel a greater sense of security after an ICD is implanted.…”

Section: Efficacymentioning

confidence: 99%

“…(2) Electrical storms of VF and polymorphic ventricular tachycardia (PVT) occurring within a few hours are not infrequently observed in the Brugada syndrome. [11][12][13][14] Arrhythmic storms may lead to multiple ICD discharges with various consequences: need for emergency hospitalization, psychological disorders, 15 proarrhythmia, 16 deleterious effect on cardiac function, 17 electromechanical dissociation, 18 and even death. 19 (3) Although the incidence of ICD related complications is low, it is far from nil.…”

Section: Limitationsmentioning

confidence: 99%

The Brugada Syndrome: Is an Implantable Cardioverter Defibrillator the Only Therapeutic Option?

Belhassen

Viskin

Antzelevitch

2002

Pacing Clinical Electrophis

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“…[1][2][3][4][5][6][7][8][9][10][11] The clinical characteristics and the variability of the typical ECG features under autonomic modulation indicate the potential role of the cardiac autonomic nervous system in the pathogenesis and arrhythmogenesis of BS. 12 Cardiac autonomic neuropathy (CAN) can be assessed using simple non-invasive tests: the Valsalva manoeuvre, beat-to-beat heart rate variation, postural fall in blood pressure, and the sustained handgrip test.…”

Section: Introductionmentioning

confidence: 99%

Significance of cardiac autonomic neuropathy in risk stratification of Brugada syndrome

Bigi

Aslani

2008

Europace

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Aims Risk stratification in Brugada syndrome (BS) is controversial especially in asymptomatic individuals. The aim of this study was to evaluate the significance of cardiac autonomic neuropathy (CAN) in BS. Methods and results Patients diagnosed with Brugada ECG pattern were enrolled in the study. Four standard cardiac autonomic function tests were performed. The presence of 2 abnormal test results were considered definite evidence for the presence of CAN. Types 1, 2, and 3 Brugada ECG pattern were found in 28, 56, and 31 patients, respectively. CAN was detected in 13 (46%) patients with type 1 Brugada ECG pattern. In contrast, none of the type 2 or 3 Brugada patients had CAN. Of 13 patients with CAN, 11 had previous history of cardiac events (84%), whereas only 2 of 15 patients without CAN had history of previous cardiac events (13%; P ¼ 0.01). The most noteworthy finding was that all of the type 1 Brugada patients with CAN were male (CAN was not detected in females). Conclusions It was concluded that CAN is an important risk indicator in BS. CAN is more common in men. Male gender, per se, is not an independent risk factor for development of ventricular arrhythmia but also CAN, which is an important risk factor in BS, is more common in men; therefore men are susceptible to the development of cardiac events.

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Near Fatal Electrical Storm in a Patient Equipped with an Implantable Cardioverter Defibrillator for Brugada Syndrome

Cited by 30 publications

References 7 publications

Catheter Ablation for the Treatment of Electrical Storm in Patients With Implantable Cardioverter-Defibrillators

Catheter Ablation for the Treatment of Electrical Storm in Patients With Implantable Cardioverter-Defibrillators

The Brugada Syndrome: Is an Implantable Cardioverter Defibrillator the Only Therapeutic Option?

Significance of cardiac autonomic neuropathy in risk stratification of Brugada syndrome

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