Epicardial Ablation in Brugada Syndrome

Pier D Lambiase; Rui Providência

doi:10.1016/j.ccep.2020.04.006

Epicardial Ablation in Brugada Syndrome

Card Electrophysiol Clin. 2020 Sep;12(3):345-356. doi: 10.1016/j.ccep.2020.04.006. Epub 2020 Jun 27.

Authors

Pier D Lambiase¹, Rui Providência²

Affiliations

¹ St Bartholomew's Hospital, Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK; Institute of Cardiovascular Science, University College of London, London, UK. Electronic address: p.lambiase@ucl.ac.uk.
² St Bartholomew's Hospital, Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK; Institute of Health Informatics, University College of London, London, UK.

PMID: 32771188
DOI: 10.1016/j.ccep.2020.04.006

Abstract

Brugada syndrome is an inherited cardiac condition characterized by a typical electrocardiogram signature of coved-type ST-segment elevation in the right precordial leads and ventricular arrhythmias leading to sudden cardiac death, in the absence of unequivocal structural heart disease. Brugada syndrome specifically affects the right ventricle, which predisposes to cardiac arrest. Besides medical management with quinidine, emerging data indicate that catheter ablation can help reduce the ventricular arrhythmia burden in these patients. This review explores the mechanisms of ventricular arrhythmia, current approaches and evidence for ablating the epicardial arrhythmogenic substrate in this condition.

Keywords: Arrhythmia; Channelopathies; Depolarization abnormalities; Mapping; Repolarization abnormalities; Sudden cardiac death; Triggers; Ventricular fibrillation; substrate.

Publication types

Review

MeSH terms

Brugada Syndrome* / diagnosis
Brugada Syndrome* / physiopathology
Brugada Syndrome* / surgery
Catheter Ablation*
Epicardial Mapping*
Humans