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Long-Term Outcomes of Brugada Substrate Ablation: A Report from BRAVO (Brugada Ablation of VF Substrate Ongoing Multicenter Registry).

Title: Long-Term Outcomes of Brugada Substrate Ablation: A Report from BRAVO (Brugada Ablation of VF Substrate Ongoing Multicenter Registry).
Authors: Nademanee, K; Chung, F-P; Sacher, F; Nogami, A; Nakagawa, H; Jiang, C; Hocini, M; Behr, E; Veerakul, G; Jan Smit, J; Wilde, AAM; Chen, S-A; Yamashiro, K; Sakamoto, Y; Morishima, I; Das, MK; Khongphatthanayothin, A; Vardhanabhuti, S; Haissaguerre, M
Publisher Information: American Heart Association
Publication Year: 2023
Collection: St George's University of London: Repository
Description: BACKGROUND: Treatment options for high-risk Brugada syndrome (BrS) with recurrent ventricular fibrillation (VF) are limited. Catheter ablation is increasingly performed but a large study with long-term outcome data is lacking. We report the results of the multicenter, international BRAVO (Brugada Ablation of VF Substrate Ongoing Registry) for treatment of high-risk symptomatic BrS. METHODS: We enrolled 159 patients (median age 42 years; 156 male) with BrS and spontaneous VF in BRAVO; 43 (27%) of them had BrS and early repolarization pattern. All but 5 had an implantable cardioverter-defibrillator for cardiac arrest (n=125) or syncope (n=34). A total of 140 (88%) had experienced numerous implantable cardioverter-defibrillator shocks for spontaneous VF before ablation. All patients underwent a percutaneous epicardial substrate ablation with electroanatomical mapping except for 8 who underwent open-thoracotomy ablation. RESULTS: In all patients, VF/BrS substrates were recorded in the epicardial surface of the right ventricular outflow tract; 45 (29%) patients also had an arrhythmic substrate in the inferior right ventricular epicardium and 3 in the posterior left ventricular epicardium. After a single ablation procedure, 128 of 159 (81%) patients remained free of VF recurrence; this number increased to 153 (96%) after a repeated procedure (mean 1.2±0.5 procedures; median=1), with a mean follow-up period of 48±29 months from the last ablation. VF burden and frequency of shocks decreased significantly from 1.1±2.1 per month before ablation to 0.003±0.14 per month after the last ablation (P
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 1524-4539
Relation: https://openaccess.sgul.ac.uk/id/eprint/115283/13/CIRCULATIONAHA.122.063367.pdf; https://openaccess.sgul.ac.uk/id/eprint/115283/8/circ_circulationaha-2022-063367_supp1.pdf; Nademanee, K; Chung, F-P; Sacher, F; Nogami, A; Nakagawa, H; Jiang, C; Hocini, M; Behr, E; Veerakul, G; Jan Smit, J; et al. Nademanee, K; Chung, F-P; Sacher, F; Nogami, A; Nakagawa, H; Jiang, C; Hocini, M; Behr, E; Veerakul, G; Jan Smit, J; Wilde, AAM; Chen, S-A; Yamashiro, K; Sakamoto, Y; Morishima, I; Das, MK; Khongphatthanayothin, A; Vardhanabhuti, S; Haissaguerre, M (2023) Long-Term Outcomes of Brugada Substrate Ablation: A Report from BRAVO (Brugada Ablation of VF Substrate Ongoing Multicenter Registry). Circulation, 147 (21). pp. 1568-1578. ISSN 1524-4539 https://doi.org/10.1161/CIRCULATIONAHA.122.063367 SGUL Authors: Behr, Elijah Raphael
DOI: 10.1161/CIRCULATIONAHA.122.063367
Availability: https://openaccess.sgul.ac.uk/id/eprint/115283/; https://openaccess.sgul.ac.uk/id/eprint/115283/13/CIRCULATIONAHA.122.063367.pdf; https://doi.org/10.1161/CIRCULATIONAHA.122.063367
Rights: cc_by_nc_4
Accession Number: edsbas.B8AED68D
Database: BASE