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Dendramis G. Implantable loop recorders in patients with Brugada syndrome: the importance of a correct patient stratification. Eur Heart J 2024; 45:2894. [PMID: 38973020 DOI: 10.1093/eurheartj/ehae393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Affiliation(s)
- Gregory Dendramis
- Cardiovascular Department, Clinical and Interventional Arrhythmology, ARNAS Ospedale Civico Di Cristina Benfratelli, Piazza Nicola Leotta 4 - 90127, Palermo, Italy
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Dijkshoorn LA, Smeding L, Pepplinkhuizen S, de Veld JA, Knops RE, Olde Nordkamp LRA. Fifteen years of subcutaneous implantable cardioverter-defibrillator therapy: Where do we stand, and what will the future hold? Heart Rhythm 2024:S1547-5271(24)02741-3. [PMID: 38908460 DOI: 10.1016/j.hrthm.2024.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 06/24/2024]
Abstract
The subcutaneous implantable cardioverter-defibrillator (S-ICD) has emerged as a feasible alternative to the transvenous ICD in the treatment of ventricular tachyarrhythmias in patients without indications for pacing or cardiac resynchronization therapy. Since its introduction, numerous innovations have been made and clinical experience has been gained, leading to its adoption in current practice and preference in certain populations. Moreover, emerging technologies like the extravascular ICD and the combination of the S-ICD with the leadless pacemaker offer new possibilities for the future. These advancements underscore the evolving role of the S-ICD in management of ventricular tachyarrhythmias. This review outlines implantation considerations, patient selection, and troubleshooting advancements in the last 15 years and provides insights into future perspectives.
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Affiliation(s)
- Leonard A Dijkshoorn
- Department of Cardiology, Amsterdam UMC, Heart Center, Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
| | - Lonneke Smeding
- Department of Cardiology, Amsterdam UMC, Heart Center, Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
| | - Shari Pepplinkhuizen
- Department of Cardiology, Amsterdam UMC, Heart Center, Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
| | - Jolien A de Veld
- Department of Cardiology, Amsterdam UMC, Heart Center, Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
| | - Reinoud E Knops
- Department of Cardiology, Amsterdam UMC, Heart Center, Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
| | - Louise R A Olde Nordkamp
- Department of Cardiology, Amsterdam UMC, Heart Center, Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands.
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Eckardt L, Veltmann C. More than 30 years of Brugada syndrome: a critical appraisal of achievements and open issues. Herzschrittmacherther Elektrophysiol 2024; 35:9-18. [PMID: 38085327 DOI: 10.1007/s00399-023-00983-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 02/21/2024]
Abstract
Over the last three decades, what is referred to as Brugada syndrome (BrS) has developed from a clinical observation of initially a few cases of sudden cardiac death (SCD) in the absence of structural heart disease with ECG signs of "atypical right bundle brunch block" to a predominantly electrocardiographic, and to a lesser extent genetic, diagnosis. Today, BrS is diagnosed in patients without overt structural heart disease and a spontaneous Brugada type 1 ECG pattern regardless of symptoms. The diagnosis of BrS is less clear in those with an only transient or drug-induced type 1 Brugada pattern, but should be considered in the presence of an arrhythmic syncope, family history of BrS, or family history of sudden death. In addition to survived cardiac arrest, syncope is probably the single most decisive risk marker for future arrhythmias. For asymptomatic BrS, risk stratification remains challenging. General recommendations to lower the risk in BrS include avoidance of drugs/agents known to induce and/or increase right precordial ST-segment elevation, including treatment of fever with antipyretic drugs. Several ECG markers that have been associated with an increased risk of SCD have been incorporated into a recently published risk score for BrS. The aim of this article is to provide an overview of the status of risk stratification and to illustrate open issues und gaps in evidence in BrS.
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Affiliation(s)
- Lars Eckardt
- Department for Cardiology II: Electrophysiology, University Hospital Münster, Münster, Germany.
- Klinik für Kardiologie II-Rhythmologie, Universitätsklinikum Münster, Münster, Germany.
| | - Christian Veltmann
- Heart Center Bremen, Electrophysiology Bremen, Klinikum Links der Weser, Bremen, Germany
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Vilela EM, Oliveira C, Oliveira C, Torres S, Sampaio F, Primo J, Ribeiro J, Teixeira M, Oliveira M, Bettencourt N, Viamonte S, Fontes-Carvalho R. Sixty years of the Bruce protocol: reappraising the contemporary role of exercise stress testing with electrocardiographic monitoring. Porto Biomed J 2023; 8:e235. [PMID: 37846299 PMCID: PMC10575366 DOI: 10.1097/j.pbj.0000000000000235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 09/18/2023] [Indexed: 10/18/2023] Open
Abstract
The cardiovascular response to exercise has long been a focus of interest. Over a century ago, the first descriptions of electrocardiographic changes occurring during exercise highlighted the possible relevance of this dynamic assessment. In this background, the inception of the Bruce protocol circa 60 years ago allowed for a major leap in this field by providing a standardized framework with which to address this issue, by means of an integrated and structured methodology. Since then, exercise stress testing with electrocardiographic monitoring (ExECG) has become one of the most widely appraised tests in cardiovascular medicine. Notably, past few decades have been profoundly marked by substantial advances in the approach to cardiovascular disease, challenging prior notions concerning both its physiopathology and overall management. Among these, the ever-evolving presentations of cardiovascular disease coupled with the development and implementation of several novel diagnostic modalities (both invasive and noninvasive) has led to a shifting paradigm in the application of ExECG. This technique, however, has continuously shown to be of added value across various momentums of the cardiovascular continuum, as depicted in several contemporary guidelines. This review provides a pragmatical reflexion on the development of ExECG, presenting a comprehensive overview concerning the current role of this modality, its challenges, and its future perspectives.
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Affiliation(s)
- Eduardo M. Vilela
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Cátia Oliveira
- Cardiology Department, Hospital de Braga, Braga, Portugal
- Faculty of Medicine, Minho University, Braga, Portugal
| | - Cláudia Oliveira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Susana Torres
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Francisco Sampaio
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
- Cardiovascular Research Center (UniC@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - João Primo
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - José Ribeiro
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Madalena Teixeira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Marco Oliveira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Nuno Bettencourt
- Cardiovascular Research Center (UniC@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sofia Viamonte
- North Rehabilitation Centre, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Ricardo Fontes-Carvalho
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
- Cardiovascular Research Center (UniC@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
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Dyrbuś M, Gąsior M, Tajstra M. Appropriate and inappropriate therapies in patients with Brugada syndrome. What to expect? Authors' reply. Europace 2023; 25:euad251. [PMID: 37611198 PMCID: PMC10481247 DOI: 10.1093/europace/euad251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 08/25/2023] Open
Affiliation(s)
- Maciej Dyrbuś
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Curie-Sklodowskiej 9, Katowice 41-800, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Curie-Sklodowskiej 9, Katowice 41-800, Poland
| | - Mateusz Tajstra
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Curie-Sklodowskiej 9, Katowice 41-800, Poland
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Dendramis G, Brugada P. Appropriate and inappropriate therapies in remotely monitored patients with Brugada syndrome: what to expect? Europace 2023; 25:euad167. [PMID: 37337665 PMCID: PMC10289808 DOI: 10.1093/europace/euad167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023] Open
Affiliation(s)
- Gregory Dendramis
- Cardiovascular Department, Clinical and Interventional Arrhythmology, ARNAS Ospedale Civico Di Cristina Benfratelli, Piazza Nicola Leotta 4, 90127, Palermo, Italy
- Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium
| | - Pedro Brugada
- Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium
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Dendramis G, Brugada P. Ventricular arrhythmias related to COVID-19 infection and vaccination in patients with Brugada syndrome: The importance of a correct patient stratification. J Cardiovasc Electrophysiol 2023; 34:1508-1509. [PMID: 37265020 DOI: 10.1111/jce.15959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 05/21/2023] [Indexed: 06/03/2023]
Affiliation(s)
- Gregory Dendramis
- Department of Cardiovascular, Clinical and Interventional Arrhythmology, ARNAS Ospedale Civico Di Cristina Benfratelli, Palermo, Italy
- Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium
| | - Pedro Brugada
- Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium
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Dendramis G, Brugada P. The Role of Inflammation and Gender Differences in the Pathogenesis of Cardiac Arrhythmias. JACC Basic Transl Sci 2023; 8:751. [PMID: 37426529 PMCID: PMC10322882 DOI: 10.1016/j.jacbts.2023.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Affiliation(s)
- Gregory Dendramis
- ARNAS Ospedale Civico Di Cristina Benfratelli, Piazza Nicola Leotta 4, 90127 Palermo, Italy
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