Epicardial Ablation in Brugada Syndrome
Brugada SyndromeThis prospective study evaluates the methodology and results of epicardial mapping/ablation in a large series of consecutive selected BrS patients and to verify if RFA could normalize the consequences of a genetic disease.
Detection of Electrocardiographic Brugada Patterns Using High Precordial Leads
Brugada ECG PatternsDetection of prevalence of Brugada patterns in our locality in asymptomatic patients , by standard 12 lead ECG level and high precordial ECG level, measuring how much the high precordial leads is more sensitive in Brugada patterns detection than standard level 12 lead ECG in our upper Egyptian population.
Safety of Local Dental Anesthesia in Patients With Cardiac Channelopathies
ChannelopathiesBrugada Syndrome3 morePatients with cardiac channelopathies needing restorative dental treatment will be included in two sessions of the study, using local dental anesthetic: lidocaine 2% with epinephrine and lidocaine 2% without vasoconstrictor. The safety of the use of two cartridges (3.6 mL) will be evaluated. The patients will be their own control and will be assessed by Holter monitoring for 28 hours, blood pressure measurement and anxiety measuring.
Validation Of A New S-ICD Algorithm To Reduce Oversensing Of Dynamic T-Waves In Patients With Brugada...
Brugada Syndrome 1SThe main objective of this study will be to assess the efficacy of S-ICD with SMART Pass to discriminate dynamic T-waves amplitudes and morphologies over time. Pilot, multi-centric, prospective, blinded, one arm (repeated measures), non-interventional study. Objective is to setup a 8-center data collection registry between Switzerland, Italy and Belgium.
AnalyST & Brugada Syndrome - Feasibility Study
Brugada SyndromeBrugada syndrome is characterized by a ST shift on the surface ECG, and a specific morphology of the Twave. This ECG abnormality is called a type 1-ECG, and is variable in time. Patients presenting a Brugada syndrome are exposed to sudden cardiac death, although it's difficult to predict patients at high risk. It is suspected that the type 1-ECG burden might be correlated to the ventricular fibrillation risk of these patients, but there is no mean to record the ECG over a long period of time. The objective of the study is to evaluate the correlation between ST elevation on the electrocardiogram (ECG) and ST shift on the intracardiac electrograms (EGM) recorded with the AnalyST ICD, to assess the ability of the device to detect the type 1-ECG. Patients enrolled in the study are patients already implanted with a defibrillator for their Brugada syndrome. During an Ajmalin test, which unmasks the type 1-ECG, both intracardiac EGM and surface ECG will be compared to assess the detection of the typical ST-shift by the ICD.
Long Term Monitoring for Risk of Sudden Death
Inherited Cardiac ArrhythmiasLong QT Syndrome3 moreRisk prediction in in inherited heart rhythm conditions that may cause sudden cardiac arrest or death is difficult. Sometimes the risks may be low but the loss of life in an otherwise healthy young individual is catastrophic. Clinicians often treat to the extreme to prevent this and so often those at unknown risk for a serious cardiac event are treated with an implanted cardioverter defibrillator (ICD) to protect against sudden death even though the risk is low or unknown. ICDs them selves are not without adverse events such as needing battery replacements, mechanical complications, inappropriate shocks and body image and self esteem issues for the patient. This study will use an inject able monitor that is less invasive to monitor inherited heart rhythm patients long term to help gather long term heart rhythm data (3 years) on patients with an inherited heart rhythm that will help to detect symptoms of dangerous heart rhythms so that the appropriate care can be provided.
The Response To Ajmaline Provocation in Healthy Subjects
Brugada SyndromeSudden DeathStandard, high lead and sodium channel provoked electrocardiograms of a healthy volunteers will be performed to observe the various ECG changes. Participants will the undergo detailed imaging with cardiac magnetic resonance imaging and deep genotyping to identify structural or genetic variants which might dictate the electrocardiographic patterns at rest and with sodium channel provocation.
Evaluation of Subcutaneous Implantable Cardiac Defibrillator in Brugada Patients
Brugada SyndromeS-ICD System (Implantable Defibrillator)Brugada syndrome is an inherited arrhythmia syndrome with an increased risk of syncope and sudden death resulting from episodes of polymorphic ventricular tachychardia and fibrillation. Currently, there is no medical therapy for the Brugada syndrome and the only treatment available is the implantation of an ICD. There is no discussion on the interest of the ICD implantation in secondary prevention and in patients who experienced syncope but the best therapeutic is more difficult to draw in asymptomatic patients. Recently we demonstrated that in asymptomatic patients with a spontaneous type 1 aspect of Brugada syndrome, (i) there was a significant risk of ventricular arrhythmia, (ii) the problem of inappropriate shocks can be solve with a good ICD programming and (iii) the problem of lead failure remains the main problem in this young population very active and represent the main limitation to larger indication of ICD implantation in this population with a very long life expectancy as these patients had a normal life expectancy except the risk of ventricular arrhythmia. In this context the S-ICD System (Boston Scientific Inc.) which is an implantable defibrillator technology that treats ventricular tachyarrhythmias using a subcutaneous pulse generator and electrode system rather than a transvenous lead system, represents a very attractive opportunity as it gives the possibility to protect the patients of the risk of ventricular arrhythmia with no risk of lead failure. However, as this is a new technology and as Brugada syndrome patients are a very specific population (very active patients, specific and changing over time ECG aspect that is at risk of T wave over sensing and high risk of SVT), it seems important to evaluate the effectiveness and the safety of S-ICD in this specific context.
Feasibility of Improving Risk Stratification in Brugada Syndrome
Brugada SyndromeCardiac Arrest3 moreFeasibility of Improving Risk Stratification in Brugada Syndrome (BrS), retrospective cohort study To study the reproducibility and specificity of V-CoS for activation heterogeneities predisposing to VT/VF in a larger series of BrS patients and determining the incidence of low V-CoS score in a larger cohort of control patients. Population of 10 patients undergoing ablation for non-VT arrhythmia, 10 patients with atrial fibrillation, 10 relatives of BrS sufferers, who have confirmation of no pathology,10 patients with previous out-of-hospital cardiac arrest due to ischaemia, but with full revascularisation and recovery of left ventricular function, 10 elite athletes, 50 BrS sufferers with previous sudden cardiac death or appropriate Implantable cardioverter-defibrillator (ICD) therapy for VT/VF. DURATION 3 years
Diagnostic Value and Safety of Flecainide Infusion Test in Brugada Syndrome
Brugada SyndromeArrhythmogenic Right Ventricular CardiomyopathyThe study aims to use flecainide infusion test as diagnostic test to unmask concealed Brugada Syndrome cases. It proposes to assess the safety profile of this test in US patients and its higher sensitivity when compared to procainamide infusion (the conventional drug used in the USA). As a substudy it proposes to apply this test to early ARVC cases in order to evaluate if ECG changes similar to those seen in Brugada Syndrome could be unmasked by flecainide iv.