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

  • Wakamiya Akinori
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiology, Faculty of Medicine, University of Tsukuba
  • Kamakura Tsukasa
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Shinohara Tetsuji
    Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
  • Yodogawa Kenji
    Department of Cardiovascular Medicine, Nippon Medical School
  • Murakoshi Nobuyuki
    Department of Cardiology, Faculty of Medicine, University of Tsukuba
  • Morita Hiroshi
    Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
  • Takahashi Naohiko
    Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
  • Inden Yasuya
    Department of Cardiology, Nagoya University Graduate School of Medicine
  • Shimizu Wataru
    Department of Cardiovascular Medicine, Nippon Medical School
  • Nogami Akihiko
    Department of Cardiology, Faculty of Medicine, University of Tsukuba
  • Horie Minoru
    Center for Epidemiologic Research in Asia and Department of Cardiovascular Medicine, Shiga University of Medical Science
  • Nakajima Kenzaburo
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Kataoka Naoya
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Wada Mitsuru
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Yamagata Kenichiro
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Ishibashi Kohei
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Inoue Yuko
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Miyamoto Koji
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Nagase Satoshi
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Noda Takashi
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Aiba Takeshi
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Yasuda Satoshi
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
  • Ieda Masaki
    Department of Cardiology, Faculty of Medicine, University of Tsukuba
  • Kusano Kengo
    Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

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Abstract

<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>

Journal

  • Circulation Journal

    Circulation Journal 84 (12), 2158-2165, 2020-11-25

    The Japanese Circulation Society

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