Karakasis Paschalis, Theofilis Panagiotis, Pamporis Konstantinos, Antoniadis Antonios P, Fragakis Nikolaos
Second Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.
First Department of Cardiology, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece.
Med Sci (Basel). 2025 Aug 6;13(3):115. doi: 10.3390/medsci13030115.
: Catheter ablation of the arrhythmogenic substrate has emerged as a promising therapeutic strategy for symptomatic Brugada syndrome (BrS). However, high-quality comparative evidence against conventional implantable cardioverter-defibrillator (ICD)-based management remains limited. : This meta-analysis aimed to evaluate the efficacy of catheter ablation in reducing ventricular fibrillation (VF) recurrence in symptomatic BrS compared to standard therapy. : Medline, Cochrane Library, and Scopus were systematically searched through 1 June 2025. Study selection, data extraction, and quality assessment were independently conducted by three reviewers. Random-effects meta-analyses were used to pool risk estimates. : Three studies (two randomized controlled trials, one observational cohort; 130 symptomatic BrS patients) were included. Over a median follow-up of 3.9 years, catheter ablation was associated with a significantly lower risk of VF recurrence compared to standard therapy [risk ratio (RR) = 0.19, 95% confidence interval (CI) = (0.06, 0.60); I = 36%, p for heterogeneity = 0.21], with no deaths reported in any group. A sensitivity analysis restricted to randomized trials confirmed similar findings in favor of ablation. : Catheter ablation was associated with reduced VF recurrence compared to ICD therapy alone, supporting its potential role as first-line treatment in symptomatic BrS or as an alternative for patients who decline ICD implantation.
针对致心律失常基质的导管消融已成为有症状的Brugada综合征（BrS）一种有前景的治疗策略。然而，与基于传统植入式心脏复律除颤器（ICD）的治疗相比，高质量的对比证据仍然有限。：本荟萃分析旨在评估与标准治疗相比，导管消融在降低有症状BrS患者室颤（VF）复发方面的疗效。：通过检索至2025年6月1日的Medline、Cochrane图书馆和Scopus数据库进行系统检索。研究选择、数据提取和质量评估由三位审阅者独立进行。采用随机效应荟萃分析来汇总风险估计值。：纳入三项研究（两项随机对照试验、一项观察性队列研究；130例有症状的BrS患者）。在中位随访3.9年期间，与标准治疗相比，导管消融与显著更低的VF复发风险相关[风险比（RR）=0.19，95%置信区间（CI）=（0.06，0.60）；I² = 36%，异质性p值 = 0.21]，且任何组均未报告死亡病例。限于随机试验的敏感性分析证实了支持消融的类似结果。：与单独的ICD治疗相比，导管消融与VF复发减少相关，支持其作为有症状BrS一线治疗或拒绝植入ICD患者替代治疗的潜在作用。
