AIMS: In the past few years, promising results were described in targeting the arrhythmogenic substrate of the epicardial right ventricular outflow tract (RVOT) region in patients with Brugada syndrome (BrS). In this report, we describe our experience with endo- and epicardial substrate mapping and ablation in a series of highly symptomatic BrS patients. METHODS: This case series consists of seven patients with clinical BrS diagnosis who underwent catheter ablation in two Dutch hospitals (Isala hospital Zwolle; and Amsterdam University Medical Centre, location AMC, Amsterdam) and Hamad Heart Hospital in Qatar between 2013 and 2017. All patients had an ICD and recurrent ventricular arrhythmia (VA) episodes. All patients underwent endo-and epicardial mapping of the RVOT region. Elimination of all abnormal potentials and disappearance of BrS ECG pattern during the ablation procedure was the aimed endpoint. RESULTS: The study group consisted of seven patients with mean age 45.6 ± 16.9 years. Five patients had SCN5A mutations. One patient was excluded from analysis, since ablation could not be performed due to a very large low-voltage area and was later diagnosed with arrhythmogenic right ventricular cardiomyopathy, associated with an SCN5A mutation. One patient underwent both endo- and epicardial ablation to eliminate VA. During a mean follow-up of 3.6 ± 1.5 years, 5/6 patients remained VA free with two patients continuing quinidine. CONCLUSION: In patients with BrS and drug-refractory VA, ablation of the arrhythmogenic substrate in the RVOT region was associated with excellent long-term VA-free survival. The majority of these highly symptomatic BrS patients had an SCN5A mutation and also low-voltage areas epicardially.
AIMS: In the past few years, promising results were described in targeting the arrhythmogenic substrate of the epicardial right ventricular outflow tract (RVOT) region in patients with Brugada syndrome (BrS). In this report, we describe our experience with endo- and epicardial substrate mapping and ablation in a series of highly symptomatic BrS patients. METHODS: This case series consists of seven patients with clinical BrS diagnosis who underwent catheter ablation in two Dutch hospitals (Isala hospital Zwolle; and Amsterdam University Medical Centre, location AMC, Amsterdam) and Hamad Heart Hospital in Qatar between 2013 and 2017. All patients had an ICD and recurrent ventricular arrhythmia (VA) episodes. All patients underwent endo-and epicardial mapping of the RVOT region. Elimination of all abnormal potentials and disappearance of BrS ECG pattern during the ablation procedure was the aimed endpoint. RESULTS: The study group consisted of seven patients with mean age 45.6 ± 16.9 years. Five patients had SCN5A mutations. One patient was excluded from analysis, since ablation could not be performed due to a very large low-voltage area and was later diagnosed with arrhythmogenic right ventricular cardiomyopathy, associated with an SCN5A mutation. One patient underwent both endo- and epicardial ablation to eliminate VA. During a mean follow-up of 3.6 ± 1.5 years, 5/6 patients remained VA free with two patients continuing quinidine. CONCLUSION: In patients with BrS and drug-refractory VA, ablation of the arrhythmogenic substrate in the RVOT region was associated with excellent long-term VA-free survival. The majority of these highly symptomatic BrS patients had an SCN5A mutation and also low-voltage areas epicardially.
Authors: Silvia G Priori; Carina Blomström-Lundqvist; Andrea Mazzanti; Nico Blom; Martin Borggrefe; John Camm; Perry Mark Elliott; Donna Fitzsimons; Robert Hatala; Gerhard Hindricks; Paulus Kirchhof; Keld Kjeldsen; Karl-Heinz Kuck; Antonio Hernandez-Madrid; Nikolaos Nikolaou; Tone M Norekvål; Christian Spaulding; Dirk J Van Veldhuisen Journal: Eur Heart J Date: 2015-08-29 Impact factor: 29.983
Authors: Juan Sieira; Giuseppe Ciconte; Giulio Conte; Gian-Battista Chierchia; Carlo de Asmundis; Giannis Baltogiannis; Giacomo Di Giovanni; Yukio Saitoh; Ghazala Irfan; Rubén Casado-Arroyo; Justo Julià; Mark La Meir; Francis Wellens; Kristel Wauters; Gudrun Pappaert; Pedro Brugada Journal: Circ Arrhythm Electrophysiol Date: 2015-07-27
Authors: Michel Haïssaguerre; Fabrice Extramiana; Mélèze Hocini; Bruno Cauchemez; Pierre Jaïs; Jose Angel Cabrera; Jerónimo Farré; Gerónimo Farre; Antoine Leenhardt; Prashanthan Sanders; Christophe Scavée; Li-Fern Hsu; Rukshen Weerasooriya; Dipen C Shah; Robert Frank; Philippe Maury; Marc Delay; Stéphane Garrigue; Jacques Clémenty Journal: Circulation Date: 2003-08-18 Impact factor: 29.690
Authors: Paola G Meregalli; Hanno L Tan; Vincent Probst; Tamara T Koopmann; Michael W Tanck; Zahurul A Bhuiyan; Frederic Sacher; Florence Kyndt; Jean-Jacques Schott; J Albuisson; Philippe Mabo; Connie R Bezzina; Herve Le Marec; Arthur A M Wilde Journal: Heart Rhythm Date: 2008-11-11 Impact factor: 6.343