HHS Public Access Author manuscript Author Manuscript
Circulation. Author manuscript; available in PMC 2017 February 16. Published in final edited form as: Circulation. 2016 February 16; 133(7): 622–630. doi:10.1161/CIRCULATIONAHA.115.017885.
Programmed Ventricular Stimulation for Risk Stratification in the Brugada Syndrome: A Pooled Analysis
Author Manuscript
Jakub Sroubek, MD, PhD1, Vincent Probst, MD, PhD2, Andrea Mazzanti, MD3,4, Pietro Delise, MD5, Jesus Castro Hevia, MD6, Kimie Ohkubo, MD7, Alessandro Zorzi, MD8, Jean Champagne, MD9, Anna Kostopoulou, MD10, Xiaoyan Yin, PhD11, Carlo Napolitano, MD, PhD3,4, David J. Milan, MD12,13, Arthur Wilde, MD14,15, Frederic Sacher, MD, PhD16, Martin Borggrefe, MD, PhD17,18, Patrick T. Ellinor, MD, PhD12,13,19, George Theodorakis, MD10, Isabelle Nault, MD9, Domenico Corrado, MD, PhD20, Ichiro Watanabe, MD7, Charles Antzelevitch, PhD21, Giuseppe Allocca, MD20, Silvia Priori, MD, PhD3,4, and Steven A. Lubitz, MD, MPH12,13,19 1Division
Author Manuscript Author Manuscript
of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 2Service de cardiologue du CHU de Nantes, CHU de Nantes, Hôpital Nord, Nantes Cefex, France 3Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy 4Dipartimento di Medicina, Molecolare Università di Pavia, Pavia, Italy 5Division of Cardiology, Casa di Cura Pederzoli, Peschiera del Garda (Verona), Italy 6Arrhythmia Unit, Cardiovascular Surgery and Cardiology Institute, Havana, Cuba 7Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan 8Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy 9Institut Universitaire de Cardiologie et Pneumologie de Québec, Quebec City, Canada 10Department of Electrophysiology and Pacing, Onassis Cardiac Surgery Center, Athens, Greece 11Boston University and National Heart, Lung and Blood Institute’s Framingham Heart Study, Framingham, MA 12Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA 13Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA 14Heart centre AMC, Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands 15Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, Jeddah, Kingdom of Saudi Arabia 16Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France 171st Department of Medicine-Cardiology, University Medical Centre Mannheim, Mannheim, Germany 18DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Mannheim, Germany 19Program in Medical and Population Genetics, The Broad Insitute of Harvard and MIT, Cambridge, MA 20Department of Cardiology, General Hospital of Conegliano, Conegliano, Treviso, Italy 21SUNY Upstate Medical University, Syracuse, NY
Correspondence: Steven A. Lubitz, MD, MPH, Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, 55 Fruit Street, GRB 109, Boston, MA 02114, Phone: 617-643-7339, Fax: 617-726-3852, [email protected]. Disclosures: Dr. Priori acknowledges receiving speaker’s fees from Medtronic and Boston Scientific. Dr. Wilde serves on the scientific advisory board of Sorin. Dr. Borggrefe has received speaker’s fees from Medtronic, St. Jude, Boehringer and Bayer. Dr. Borggrefe is an advisory board member of Impulse dynamics and steering committee member of INNOVATE HF, a trial conducted by Biocontrol.
Sroubek et al.
Page 2
Abstract Author Manuscript
Background—The role of programmed ventricular stimulation (PVS) in identifying Brugada syndrome patients at highest risk for sudden death is uncertain.
Author Manuscript
Methods and Results—We performed a systematic review and pooled analysis of prospective observational studies of Brugada syndrome patients without a history of sudden cardiac arrest who underwent PVS. We estimated incidence rates and relative hazards of cardiac arrest or ICD shock. We analyzed individual-level data from 8 studies, comprising 1312 patients who experienced 65 cardiac events (median follow-up of 38.3 months). A total of 527 patients were induced into arrhythmias with up to triple extrastimuli. Induction was associated with cardiac events during follow-up (HR 2.66, 95%CI 1.44–4.92, P
Circulation. Author manuscript; available in PMC 2017 February 16. Published in final edited form as: Circulation. 2016 February 16; 133(7): 622–630. doi:10.1161/CIRCULATIONAHA.115.017885.
Programmed Ventricular Stimulation for Risk Stratification in the Brugada Syndrome: A Pooled Analysis
Author Manuscript
Jakub Sroubek, MD, PhD1, Vincent Probst, MD, PhD2, Andrea Mazzanti, MD3,4, Pietro Delise, MD5, Jesus Castro Hevia, MD6, Kimie Ohkubo, MD7, Alessandro Zorzi, MD8, Jean Champagne, MD9, Anna Kostopoulou, MD10, Xiaoyan Yin, PhD11, Carlo Napolitano, MD, PhD3,4, David J. Milan, MD12,13, Arthur Wilde, MD14,15, Frederic Sacher, MD, PhD16, Martin Borggrefe, MD, PhD17,18, Patrick T. Ellinor, MD, PhD12,13,19, George Theodorakis, MD10, Isabelle Nault, MD9, Domenico Corrado, MD, PhD20, Ichiro Watanabe, MD7, Charles Antzelevitch, PhD21, Giuseppe Allocca, MD20, Silvia Priori, MD, PhD3,4, and Steven A. Lubitz, MD, MPH12,13,19 1Division
Author Manuscript Author Manuscript
of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 2Service de cardiologue du CHU de Nantes, CHU de Nantes, Hôpital Nord, Nantes Cefex, France 3Molecular Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy 4Dipartimento di Medicina, Molecolare Università di Pavia, Pavia, Italy 5Division of Cardiology, Casa di Cura Pederzoli, Peschiera del Garda (Verona), Italy 6Arrhythmia Unit, Cardiovascular Surgery and Cardiology Institute, Havana, Cuba 7Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan 8Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy 9Institut Universitaire de Cardiologie et Pneumologie de Québec, Quebec City, Canada 10Department of Electrophysiology and Pacing, Onassis Cardiac Surgery Center, Athens, Greece 11Boston University and National Heart, Lung and Blood Institute’s Framingham Heart Study, Framingham, MA 12Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA 13Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA 14Heart centre AMC, Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands 15Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, Jeddah, Kingdom of Saudi Arabia 16Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France 171st Department of Medicine-Cardiology, University Medical Centre Mannheim, Mannheim, Germany 18DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Mannheim, Germany 19Program in Medical and Population Genetics, The Broad Insitute of Harvard and MIT, Cambridge, MA 20Department of Cardiology, General Hospital of Conegliano, Conegliano, Treviso, Italy 21SUNY Upstate Medical University, Syracuse, NY
Correspondence: Steven A. Lubitz, MD, MPH, Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, 55 Fruit Street, GRB 109, Boston, MA 02114, Phone: 617-643-7339, Fax: 617-726-3852, [email protected]. Disclosures: Dr. Priori acknowledges receiving speaker’s fees from Medtronic and Boston Scientific. Dr. Wilde serves on the scientific advisory board of Sorin. Dr. Borggrefe has received speaker’s fees from Medtronic, St. Jude, Boehringer and Bayer. Dr. Borggrefe is an advisory board member of Impulse dynamics and steering committee member of INNOVATE HF, a trial conducted by Biocontrol.
Sroubek et al.
Page 2
Abstract Author Manuscript
Background—The role of programmed ventricular stimulation (PVS) in identifying Brugada syndrome patients at highest risk for sudden death is uncertain.
Author Manuscript
Methods and Results—We performed a systematic review and pooled analysis of prospective observational studies of Brugada syndrome patients without a history of sudden cardiac arrest who underwent PVS. We estimated incidence rates and relative hazards of cardiac arrest or ICD shock. We analyzed individual-level data from 8 studies, comprising 1312 patients who experienced 65 cardiac events (median follow-up of 38.3 months). A total of 527 patients were induced into arrhythmias with up to triple extrastimuli. Induction was associated with cardiac events during follow-up (HR 2.66, 95%CI 1.44–4.92, P
![[Risk stratification for sudden cardiac death in ischemic heart disease. Programmed ventricular stimulation].](/assets/img/hold.png)
