Improved Risk Stratification of Patients With Brugada Syndrome by the New Japanese Circulation Society Guideline : A Multicenter Validation Study

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  • Wilde Arthur A.M.
    Heart Centre, Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centre, University of Amsterdam

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  • Importance of Validating Guideline Recommendations

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<p>Background:The new guideline (NG) published by the Japanese Circulation Society (JCS) places emphasis on previous arrhythmic syncope and inducibility of ventricular fibrillation (VF) by ≤2 extrastimuli during programmed electrical stimulation (PES) for deciding the indication of an implantable cardioverter-defibrillator in patients with Brugada syndrome (BrS). This study evaluated the usefulness of the NG and compared it with the former guideline (FG) for risk stratification of patients with BrS.</p><p>Methods and Results:This was a multicenter (7 Japanese hospitals) retrospective study involving 234 patients with BrS who underwent PES at baseline (226 males; mean age at diagnosis: 44.9±13.4 years). At diagnosis, 46 patients (20%) had previous VF, 100 patients (43%) had previous syncope, and 88 patients (37%) were asymptomatic. We evaluated the difference in the incidence of VF in each indication according to the new and FGs. During the follow-up period (mean: 6.9±5.2 years), the incidence of VF was higher in patients with Class IIa indication according to the NG (NG: 16/45 patients [35.6%] vs. FG: 16/104 patients [15.4%]), while the incidence of VF in patients with other than class I or IIa indication was similarly low in both guidelines (NG: 2/143 patients [1.4%] vs. FG: 2/84 patients [2.4%]).</p><p>Conclusions:This study validated the usefulness of the NG for risk stratification of BrS patients.</p>

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  • Circulation Journal

    Circulation Journal 84 (12), 2136-2137, 2020-11-25

    一般社団法人 日本循環器学会

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