Optimizing the clinical use of implantable defibrillators in patients with Brugada syndrome

Abstract

Our review highlights the difficulties we face when treating patients with Brugada syndrome (BS) by an implantable cardioverter defibrillator (ICD). Higher defibrillation thresholds, high inappropriate shock rates because of sinus tachycardia and supraventricular tachycardias, T wave oversensing, and high lead failure rates should be expected. Psychosocial adjustment problems also occur frequently in this patient population. These high complications rates are because of specific characteristics of the BS patient population, consisting of young, active patients with a primary electrical disease. The management strategies include prevention and early recognition of the expected complications. Additionally, individualized careful programming of the ICD is essential to ensure maximal safety and minimal complication rates in patients with BS. © The Author 2007.