Citations 2
Clinical Management of Brugada Syndrome: Commentary From the Experts
Cutler, Michael J. , Eckhardt, Lee L. , Kaufman, Elizabeth S. , Arbelo, Elena , Behr, Elijah R. , Brugada, Pedro , Crotti, Lia , Asmundis, Carlo de , Horie, Minoru , Huang, David T. , Lubitz, Steven A. , Mackall, Judith A. , Roden, Dan M. , Sacher, Frédéric , Shoemaker, Benjamin, Sy, Raymond W. , Watanabe, Atsuyuki , Wilde, Arthur A.M. , Cerrone, Marina , Crotti, Lia , deAsmundis, Carlo , Gollob, Michael H , Horie, Minoru , Huang, David T , Krahn, Andrew D , London, Barry , Lubitz, Steven A , Mackall, Judith A , Nademanee, Koonlawee , Perez, Marco V , Probst, Vincent , Roden, Dan M. , Sacher, Frederic , Sarquella-Brugada, Georgia , Scheinman, Melvin M , Shimizu, Wataru , Shoemaker, M Benjamin , Sy, Raymond W , Wilde, Arthur A M , Behr, Elijah Raphael , Eckhardt, Lee L , Arbelo, Elena , Cerrone, Marina , Gollob, Michael H. , Krahn, Andrew D. , London, Barry , Nademanee, Koonlawee , Pérez, Marco
Circulation: Arrhythmia and Electrophysiology | December 15, 2023 | Volume: 17 | Issue: 1 | Pages: No page available
Although there is consensus on the management of patients with Brugada Syndrome with high risk for sudden cardiac arrest, asymptomatic or intermediate-risk patients present clinical management challenges. This document explores the management opinions of experts throughout the world for patients with Brugada Syndrome who do not fit guideline recommendations. Four real-world clinical scenarios were presented with commentary from small expert groups for each case. All authors voted on case-specific questions to evaluate the level of consensus among the entire group in nuanced diagnostic and management decisions relevant to each case. Points of agreement, points of controversy, and gaps in knowledge are highlighted.
Cryoballoon ablation vs. antiarrhythmic drugs: first-line therapy for patients with paroxysmal atrial fibrillation
Kuniss, Malte , Pavlović, Nikola , Hermida, J S, Healey, Stewart, Arena, Giuseppe , Badenco, Nicolas , Meyer, Christian , Chen, Jian , Iacopino, Saverio , Anselme, Frédéric , Packer, Douglas L. , Pitschner, Heinz-Friedrich, Asmundis, Carlo de , Willems, Stephan , Piazza, Fabio Di , Becker, Daniel , Chierchia, Gian‐Battista , Investigators, for the Cryo-FIRST, Meyer, Christian , Anselme, Frédéric , deAsmundis, Carlo , Velagić, Vedran , Investigators, for the Cryo-FIRST
EP Europace | January 25, 2021 | Volume: 23 | Issue: 7 | Pages: 1033-1041
AbstractAimsTreatment guidelines for patients with atrial fibrillation (AF) suggest that patients should be managed with an antiarrhythmic drug (AAD) before undergoing catheter ablation (CA). This study evaluated whether pulmonary vein isolation employing cryoballoon CA is superior to AAD therapy for the prevention of atrial arrhythmia (AA) recurrence in rhythm control naive patients with paroxysmal AF (PAF).Methods and resultsA total of 218 treatment naive patients with symptomatic PAF were randomized (1 : 1) to cryoballoon CA (Arctic Front Advance, Medtronic) or AAD (Class I or III) and followed for 12 months. The primary endpoint was ≥1 episode of recurrent AA (AF, atrial flutter, or atrial tachycardia) >30 s after a prespecified 90-day blanking period. Secondary endpoints included the rate of serious adverse events (SAEs) and recurrence of symptomatic palpitations (evaluated via patient diaries). Freedom from AA was achieved in 82.2% of subjects in the cryoballoon arm and 67.6% of subjects in the AAD arm (HR = 0.48, P = 0.01). There were no group differences in the time-to-first (HR = 0.76, P = 0.28) or overall incidence [incidence rate ratio (IRR)=0.79, P = 0.28] of SAEs. The incidence rate of symptomatic palpitations was lower in the cryoballoon (7.61 days/year) compared with the AAD arm (18.96 days/year; IRR = 0.40, P < 0.001).ConclusionsCryoballoon CA was superior to AAD therapy, significantly reducing AA recurrence in treatment naive patients with PAF. Additionally, cryoballoon CA was associated with lower symptom recurrence and a similar rate of SAEs compared with AAD therapy.