SPC365

Prognostic significance of programmed ventricular stimulation in Brugada patients

Session: Sessão de Posters 28 - Morte súbita cardíaca
Speaker: Ana Margarida Martins

Congress: CPC 2024
Topic: C. Arrhythmias and Device Therapy
Theme: 08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Subtheme: 08.4 Ventricular Arrhythmias and SCD - Treatment
Session Type: Cartazes
FP Number: ---
Authors: Ana Margarida Martins; Ana Beatriz Garcia; Catarina Oliveira; Miguel Raposo; Ana Abrantes; Catarina Gregório; Joana Brito; Afonso Nunes Ferreira; Gustavo Lima da Silva; Nuno Cortez-Dias; Fausto J.Pinto; João de Sousa

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><u><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#212121"><span style="background-color:white">Introduction</span></span></span></u></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#212121"><span style="background-color:white">Brugada Syndrome (BS) is an inherited cardiac arrhythmogenic syndrome associated with an increased risk for ventricular tachyarrhythmias and sudden cardiac death. Risk assessment in&nbsp; BS is controversial, which makes the decision to use an implantable cardioverter-defibrillators (ICD) in these patients difficult. Indication and prognostic significance of programmed ventricular stimulation (PVS) is still a matter of debate. </span></span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><u><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#212121"><span style="background-color:white">Purpose</span></span></span></u></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#212121"><span style="background-color:white">To determine the association between electrophysiological study (EFS) results and arrhythmic endpoints.</span></span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><u><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Methods </span></u></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">A prospective analysis of asymptomatic BS patients followed in a tertiary hospital was conducted, considering those who have performed PVS for risk stratification. The endpoint of interest was a composite of arrhythmic death, aborted cardiac arrest and appropriately triggered ICD shock.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><u><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Results</span></u></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">We enrolled 71 asymptomatic BS patients (65% male, mean age 53 &plusmn; 13 years) with a mean follow-up time of 7 years. All patients exhibited type 1 ECG pattern, which occurred spontaneously in 61 % of patients. Programmed ventricular stimulation (PVS)&nbsp; was performed in both right ventricular apex (RVA) and right ventricular outflow tract (RVOT) in 55% of patients and isolated in RVA or RVOT in 41% and 4%, respectively.&nbsp; The protocol was performed using ventricular paced drive trains at two cycles (600 and 400 ms), adding 2 or 3 premature stimulations to ventricular refractory period. Ventricular fibrillation was induced in 32% of patients and non-sustained polymorphic ventricular tachycardia in 3% of them. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Patients with sustained or non-sustained ventricular tachycardia induced by PVS had a significantly higher arrhythmogenic event rate (arrhythmic death, aborted cardiac arrest or appropriately triggered ICD shock) during follow-up, as indicated by the Kaplan Meier curve (p=0,028, figure 1). Seventy-two percent of these patients had an ICD implanted. No patient suffered arrhythmic death. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><u><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Conclusion</span></u></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">These data suggest that in asymptomatic BS patients, inducible ventricular tachyarrhythmias during PVS are associated with arrhythmogenic events during follow-up, being of importance in risk stratification. </span></span></span></span></p>