Long-Term Complications of Implantable Defibrillator Therapy in Brugada Syndrome

Although the benefits of implantable cardioverter-defibrillator (ICD) therapy in patients with Brugada syndrome (BrS) at risk of sudden cardiac arrest are well established, these relatively young patients can encounter complications in the long term. The objective of the present study was to determine the incidence of device complications in patients with BrS during long-term follow-up. The prevalence of device-related complications and the clinical outcome were determined in 41 consecutive patients with BrS (age 48 ± 12 years; 38 men) who were treated with ICD implantation. During a median follow-up of 76 months (interquartile range 51 to 98), 15 patients (37%) experienced 21 adverse events, including 11 device-related complications in 8 (20%) and ≥1 inappropriate shock in 10 (24%). Five patients (12%) received appropriate shocks for ventricular fibrillation. Excluding inappropriate shocks, 95.1%, 89.6%, 86.6%, and 73.3% of patients were free of device-related complications at 1, 3, 5, and 7 years, respectively. Also, 92.6%, 89.8%, 89.9%, and 86.1% were free of lethal arrhythmias at 1, 3, 5, and 7 years, respectively. Adverse effects related to ICD implantation are not uncommon, and their prevalence increases with the follow-up duration required for patients with BrS. In conclusion, because complications can be encountered even very late after device implantation, asymptomatic young patients should be carefully selected and educated about the long-term outcomes of ICD therapy.