The Role of Electrophysiological Study in the Risk Stratification of Brugada Syndrome : Cardiology in Review

Journal Logo

Review Article

The Role of Electrophysiological Study in the Risk Stratification of Brugada Syndrome

Bazoukis, George MD, PhD*,†; Chung, Cheuk To MD; Vassiliou, Vassilios S MD, PhD§; Sfairopoulos, Dimitrios MD; Lee, Sharen MD; Papadatos, Stamatis S MD, PhD**; Korantzopoulos, Panagiotis MD, PhD; Saplaouras, Athanasios MD††; Letsas, Konstantinos P. MD, PhD††; Liu, Tong MD, PhD‡‡; Tse, Gary MD, PhD‡‡,§§,¶¶

Author Information
Cardiology in Review ():10.1097/CRD.0000000000000561, May 02, 2023. | DOI: 10.1097/CRD.0000000000000561

Abstract

Brugada syndrome (BrS) is a complex arrhythmogenic disease associated with an increased risk of sudden cardiac death (SCD). The role of electrophysiological study (EPS) for risk stratification purposes of asymptomatic BrS patients remains still controversial. This study aims to summarize the existing data about the role of electrophysiological study for arrhythmic risk stratification of BrS patients without a prior history of aborted SCD or fatal arrhythmic event. Two independent investigators (G.B. and G.T.) performed a systematic search in the MedLine database and Cochrane library from their inception until April 2022 without any limitations. The reference lists of the relevant research studies as well as the relevant review studies and meta-analyses were manually searched. Nineteen studies were included in the final analysis. The included studies enrolled 6218 BrS patients (mean age: 46.9 years old, males: 76%) while 4265 (68.6%) patients underwent an EPS. The quantitative synthesis showed that a positive EPS study was significantly associated with arrhythmic events in BrS patients (RR, 1.74 [1.23-2.45]; P = 0.002; I2 = 63%]. By including the studies that provided data on the association of EPS with arrhythmic events during follow-up in patients without a prior history of aborted SCD or fatal arrhythmic event, the association between positive EPS study and future arrhythmic events remained significant (RR, 1.60 [1.08-2.36]; P = 0.02; I2 = 19%). In conclusion, EPS is a useful invasive tool for the risk stratification of BrS patients and can be used to identify the population of BrS patients who may be candidates for primary prevention of SCD with implantable cardioverter-defibrillator (ICD) implantation.

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

You can read the full text of this article if you:

Access through Ovid