Incidence of Atrial Tachyarrhythmias in Patients With Early Repolarization Syndrome Analysis of Patients With Implantable Cardioverter Defibrillators

Abstract

Atrial tachyarrhythmias (ATAs) occur in a significant proportion of Brugada syndrome (BrS) patients and are often an important cause of inappropriate shocks. The aim of this retrospective study was to evaluate the incidence of ATAs and ATA-induced inappropriate shocks in early repolarization syndrome (ERS) patients as compared to BrS patients. We analyzed data from 20 consecutive patients who were diagnosed with ERS and compared them with patients diagnosed with BrS (n = 31). Clinical and LCD interrogation data were collected and analyzed for all events with LCD shocks. Three patients had a history of atrial fibrillation (AF) prior to ICD implantation. One patient had AV reentrant tachycardia and was successfully ablated before LCD implantation. ATAs were newly diagnosed in 4 patients with no prior history of AF. There were no significant differences in gender, age, or left atrial diameter between ATA development. Four (20%) of 20 consecutive patients received inappropriate ICD shocks for ATAs. One suffered from repeat inappropriate shocks triggered by paroxysmal AF and received catheter ablation for AF. ATAs were not infrequent in patients with ERS and seemed to be related to inappropriate ICD therapy. Careful LCD programming is required to reduce ATA-related inappropriate LCD shock in patients with ERS.