Department of Cardiology, Nagoya Daini Red Cross Hospital, Nagoya, Japan; Department of Cardiology, Graduate School of Medicine, Hiroshima University, Hiroshima, Japan.
Int J Cardiol. 2013 Oct 15;168(6):5273-6. doi: 10.1016/j.ijcard.2013.08.016. Epub 2013 Aug 15.
Inappropriate shocks resulting from atrial tachyarrhythmias are highly problematic for patients with an implantable cardioverter defibrillator (ICD). We aimed to determine the effectiveness of catheter ablation of atrial fibrillation (AF) in preventing inappropriate shocks due to rapid AF in patients diagnosed with Brugada syndrome (BS) who were implanted with an ICD.
We performed AF ablation in 5 BS patients with ICDs who experienced inappropriate shocks caused by rapid paroxysmal AF and in a BS patient scheduled to determine an indication of an ICD implantation who frequently experienced rapid AF.
Although 2 patients underwent a 2nd ablation procedure because of AF recurrences, 5 of the 6 patients were finally free from AF after their last procedure during a median follow-up period of 43.2 months. No further inappropriate shocks caused by rapid AF occurred after the 1st ablation session in any of the patients. A patient developed a ventricular fibrillation storm during his electrophysiological study following the ablation procedure, and then was implanted with an ICD.
AF ablation in BS patients may be reasonable to prevent inappropriate ICD shocks resulting from rapid AF. However, ventricular extrastimuli just after the ablation had better be avoided in them.
植入式心脏复律除颤器（ICD）患者的房性快速性心律失常引发的不恰当电击是一个大问题。我们旨在确定导管消融心房颤动（AF）在预防因诊断为Brugada 综合征（BS）并植入 ICD 的患者快速 AF 引起的不恰当电击的有效性。
我们对 5 例因阵发性快速 AF 而导致不恰当电击且 ICD 引发快速 AF 频繁发作的 BS 患者进行了 AF 消融。
尽管有 2 例患者因 AF 复发进行了第 2 次消融，但在中位随访 43.2 个月期间，6 例患者中的 5 例最终不再发生 AF。在任何患者中，第 1 次消融后均未再发生因快速 AF 引起的不恰当电击。1 例患者在消融后行电生理研究时发生室颤风暴，随后植入 ICD。
BS 患者的 AF 消融可能合理，可预防因快速 AF 导致的 ICD 不恰当电击。然而，消融后应尽量避免心室期外刺激。
