Improved Risk Stratification of Patients With Brugada Syndrome by the New Japanese Circulation Society Guideline

DOI：

10.1253/circj.cj-19-0910

发表时间：

2020-10

期刊：

Circulation journal : official journal of the Japanese Circulation Society

影响因子：

通讯作者：

中科院分区：

其他

文献类型：

作者：

A. Wakamiya;T. Kamakura;T. Shinohara;K. Yodogawa;N. Murakoshi;H. Morita;N. Takahashi;Y. Inden;W. Shimizu;A. Nogami;M. Horie;K. Nakajima;Naoya Kataoka;M. Wada;K. Yamagata;K. Ishibashi;Y. Inoue;Koji Miyamoto;S. Nagase;T. Noda;T. Aiba;S. Yasuda;M. Ieda;K. Kusano

背景日本循环学会（JCS）发布的新指南（NG）强调既往心律失常晕厥和程序电刺激（PES）期间≤2次刺激外诱发室颤（VF）的可能性，以决定植入式心律转复除颤器的适应症Brugada综合征（BrS）患者。本研究评价了NG的有用性，并将其与之前的BrS患者风险分层指南（FG）进行了比较。方法和结果：这是一项多中心（7家日本医院）回顾性研究，涉及234例基线接受PES的BrS患者（226例男性;诊断时的平均年龄：44.9±13.4岁）。诊断时，46例患者（20%）既往有VF，100例患者（43%）既往有晕厥，88例患者（37%）无症状。我们根据新的和FG评估了每种适应症中VF发生率的差异。在随访期间（平均：6.9±5.2岁），根据NG，IIa类适应症患者的VF发生率较高（NG：16/45例患者[35.6%] vs. FG：16/104例患者[15.4%]），而在两个指南中，除I类或IIa类适应症以外的患者的VF发生率同样较低（NG：2/143例患者[1.4%] vs. FG：2/84例患者[2.4%]）。结论：本研究验证了NG对BrS患者危险分层的有效性。

BACKGROUND The new guideline (NG) published by the Japanese Circulation Society (JCS) places emphasis on previous arrhythmic syncope and inducibility of ventricular fibrillation (VF) by ≤2 extrastimuli during programmed electrical stimulation (PES) for deciding the indication of an implantable cardioverter-defibrillator in patients with Brugada syndrome (BrS). This study evaluated the usefulness of the NG and compared it with the former guideline (FG) for risk stratification of patients with BrS.Methods and Results:This was a multicenter (7 Japanese hospitals) retrospective study involving 234 patients with BrS who underwent PES at baseline (226 males; mean age at diagnosis: 44.9±13.4 years). At diagnosis, 46 patients (20%) had previous VF, 100 patients (43%) had previous syncope, and 88 patients (37%) were asymptomatic. We evaluated the difference in the incidence of VF in each indication according to the new and FGs. During the follow-up period (mean: 6.9±5.2 years), the incidence of VF was higher in patients with Class IIa indication according to the NG (NG: 16/45 patients [35.6%] vs. FG: 16/104 patients [15.4%]), while the incidence of VF in patients with other than class I or IIa indication was similarly low in both guidelines (NG: 2/143 patients [1.4%] vs. FG: 2/84 patients [2.4%]). CONCLUSIONS This study validated the usefulness of the NG for risk stratification of BrS patients.

Improved Risk Stratification of Patients With Brugada Syndrome by the New Japanese Circulation Society Guideline - A Multicenter Validation Study.

文献摘要

相似文献