Surface Electrocardiogram Screening for Subcutaneous Implantable Cardioverter-Defibrillators in Japanese Patients With and Without Brugada Syndrome
| Autor: | Mihoko Kawabata, Shinya Shiohira, Mitsuaki Isobe, Yasuhiro Shirai, Kenzo Hirao, Masahiko Goya, Atsuhiko Yagishita, Shingo Maeda, Masakazu Kaneko, Takeshi Sasaki |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Supine position Screening test 030204 cardiovascular system & hematology Body Mass Index Electrocardiography 03 medical and health sciences QRS complex 0302 clinical medicine Asian People Japan Internal medicine Prevalence Humans Medicine 030212 general & internal medicine Aged Brugada Syndrome Brugada syndrome business.industry Incidence (epidemiology) fungi General Medicine Middle Aged medicine.disease Defibrillators Implantable Surface electrocardiogram Parasternal line Cardiology Female Cardiology and Cardiovascular Medicine business Body mass index |
| Zdroj: | Circulation Journal. 81:981-987 |
| ISSN: | 1347-4820 1346-9843 |
| DOI: | 10.1253/circj.cj-16-1295 |
| Popis: | Background Subcutaneous implantable cardioverter-defibrillators (S-ICD) could eliminate lead-associated complications. We assessed the prevalence of S-ICD ineligibility in conventional ICD recipients and compared it in patients with and without Brugada syndrome (BrS).Methods and Results:Consecutive patients with a transvenous ICD without an indication for antibradycardia pacing were assessed. A patient was considered eligible for S-ICD if the ECG satisfied the screening template, both supine and standing, in ≥1 lead. Among 130 patients (103 men, age 57±15 years), a total of 18 (13.8%) patients were ineligible. The BrS group (n=33) had a significantly higher prevalence of S-ICD screening failure as compared with the non-BrS group (P=0.003; 30% vs. 8.2%). In the BrS group, the body mass index (BMI) was significantly lower, and T/QRS amplitude in lead I was significantly higher in those who were ineligible than that in the patients who were eligible. Of the 10 BrS patients failing the screening, 4 became eligible in the right parasternal electrode position. Conclusions Among current ICD patients, there was a high incidence of patients with BrS who were unsuitable for S-ICD based on the left parasternal screening test. Suitability screening of patients for S-ICDs should be conducted carefully in patients with BrS, particularly if the BMI is low. Right parasternal electrode positioning should also be tested in such BrS patients. |
| Databáze: | OpenAIRE |
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