Long‐term of epicardial radiofrequency ablation and benefit for recurrent ventricular arrhythmia in Brugada syndrome: A systematic review and meta‐analysis
Abstract Background Brugada syndrome (BrS) is a rare cardiac channelopathy linked to an increased risk of ventricular arrhythmias (VA) and sudden cardiac death. Radiofrequency ablation (RFA), particularly epicardial ablation, is recommended for BrS patients with recurrent VA unresponsive to conventi...
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| Format: | Article |
| Language: | English |
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Wiley
2025-06-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | https://doi.org/10.1002/joa3.70073 |
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| author | Arga Setyo Adji MD Atiyatum Billah MD Juliardi Eka Putra Sit MD Bryan Gervais deLiyis MD Angga Nugraha MD Angela Puspita MD, FICEP Abdillah Maulana Satrioaji MD Ragil Nur Rosyadi MD, FIHA |
| author_facet | Arga Setyo Adji MD Atiyatum Billah MD Juliardi Eka Putra Sit MD Bryan Gervais deLiyis MD Angga Nugraha MD Angela Puspita MD, FICEP Abdillah Maulana Satrioaji MD Ragil Nur Rosyadi MD, FIHA |
| author_sort | Arga Setyo Adji MD |
| collection | DOAJ |
| description | Abstract Background Brugada syndrome (BrS) is a rare cardiac channelopathy linked to an increased risk of ventricular arrhythmias (VA) and sudden cardiac death. Radiofrequency ablation (RFA), particularly epicardial ablation, is recommended for BrS patients with recurrent VA unresponsive to conventional treatments like implantable cardioverter‐defibrillators (ICD) and quinidine. This study aims to evaluate the long‐term efficacy of epicardial RFA in preventing VA recurrence in BrS. Methods A systematic search of PubMed, ScienceDirect, Cochrane Library, and ProQuest databases was conducted following PRISMA 2020 guidelines. Studies on RFA for VA in BrS were included. Primary outcomes were VA recurrence and all‐cause mortality. Statistical analysis was performed using Review Manager 5.4. Results Epicardial, endocardial, and combined ablation strategies effectively reduced VA recurrence, decreased ICD shocks, and improved clinical outcomes in BrS. Epicardial ablation RFA near coronary arteries showed a notable reduction in VA recurrence, while endocardial ablation remained a viable alternative. Meta‐analysis revealed a significant reduction in VA recurrence (RR 0.17; 95% CI 0.07–0.43; p < .0001) and ICD shocks (RR 0.13; 95% CI 0.04–0.44; p = .001). Subgroup analysis suggested greater VA reduction with epicardial ablation, though without statistical significance. Conclusion Epicardial RFA is associated with a significant reduction in recurrent VAs (83%) and ICD shock rates (87%) in patients with BrS. The procedure demonstrates a favorable long‐term safety profile, with no mortality reported in the included studies. |
| format | Article |
| id | doaj-art-d556e8070cb04fb7a97db81fc749c92e |
| institution | Kabale University |
| issn | 1880-4276 1883-2148 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj-art-d556e8070cb04fb7a97db81fc749c92e2025-08-20T03:28:01ZengWileyJournal of Arrhythmia1880-42761883-21482025-06-01413n/an/a10.1002/joa3.70073Long‐term of epicardial radiofrequency ablation and benefit for recurrent ventricular arrhythmia in Brugada syndrome: A systematic review and meta‐analysisArga Setyo Adji MD0Atiyatum Billah MD1Juliardi Eka Putra Sit MD2Bryan Gervais deLiyis MD3Angga Nugraha MD4Angela Puspita MD, FICEP5Abdillah Maulana Satrioaji MD6Ragil Nur Rosyadi MD, FIHA7Faculty of Medicine Hang Tuah University Surabaya East Java IndonesiaFaculty of Medicine Hang Tuah University Surabaya East Java IndonesiaFaculty of Medicine Hang Tuah University Surabaya East Java IndonesiaFaculty of Medicine Udayana University Denpasar Bali IndonesiaDepartment of Cardiology, Gadjah Mada University, Yogyakarta, Center Java, Indonesia Yogyakarta Center Java IndonesiaEmergency Medicine Division, Department of Internal Medicine Hang Tuah University Surabaya East Java IndonesiaFaculty of Medicine Hang Tuah University Surabaya East Java IndonesiaDepartment of Cardiology Rumah Sakit Pusat Angkatan Laut Dr. Ramelan Surabaya East Java IndonesiaAbstract Background Brugada syndrome (BrS) is a rare cardiac channelopathy linked to an increased risk of ventricular arrhythmias (VA) and sudden cardiac death. Radiofrequency ablation (RFA), particularly epicardial ablation, is recommended for BrS patients with recurrent VA unresponsive to conventional treatments like implantable cardioverter‐defibrillators (ICD) and quinidine. This study aims to evaluate the long‐term efficacy of epicardial RFA in preventing VA recurrence in BrS. Methods A systematic search of PubMed, ScienceDirect, Cochrane Library, and ProQuest databases was conducted following PRISMA 2020 guidelines. Studies on RFA for VA in BrS were included. Primary outcomes were VA recurrence and all‐cause mortality. Statistical analysis was performed using Review Manager 5.4. Results Epicardial, endocardial, and combined ablation strategies effectively reduced VA recurrence, decreased ICD shocks, and improved clinical outcomes in BrS. Epicardial ablation RFA near coronary arteries showed a notable reduction in VA recurrence, while endocardial ablation remained a viable alternative. Meta‐analysis revealed a significant reduction in VA recurrence (RR 0.17; 95% CI 0.07–0.43; p < .0001) and ICD shocks (RR 0.13; 95% CI 0.04–0.44; p = .001). Subgroup analysis suggested greater VA reduction with epicardial ablation, though without statistical significance. Conclusion Epicardial RFA is associated with a significant reduction in recurrent VAs (83%) and ICD shock rates (87%) in patients with BrS. The procedure demonstrates a favorable long‐term safety profile, with no mortality reported in the included studies.https://doi.org/10.1002/joa3.70073Brugada syndromeepicardial radiofrequency ablationICD shocklong‐term outcomesventricular arrhythmia |
| spellingShingle | Arga Setyo Adji MD Atiyatum Billah MD Juliardi Eka Putra Sit MD Bryan Gervais deLiyis MD Angga Nugraha MD Angela Puspita MD, FICEP Abdillah Maulana Satrioaji MD Ragil Nur Rosyadi MD, FIHA Long‐term of epicardial radiofrequency ablation and benefit for recurrent ventricular arrhythmia in Brugada syndrome: A systematic review and meta‐analysis Journal of Arrhythmia Brugada syndrome epicardial radiofrequency ablation ICD shock long‐term outcomes ventricular arrhythmia |
| title | Long‐term of epicardial radiofrequency ablation and benefit for recurrent ventricular arrhythmia in Brugada syndrome: A systematic review and meta‐analysis |
| title_full | Long‐term of epicardial radiofrequency ablation and benefit for recurrent ventricular arrhythmia in Brugada syndrome: A systematic review and meta‐analysis |
| title_fullStr | Long‐term of epicardial radiofrequency ablation and benefit for recurrent ventricular arrhythmia in Brugada syndrome: A systematic review and meta‐analysis |
| title_full_unstemmed | Long‐term of epicardial radiofrequency ablation and benefit for recurrent ventricular arrhythmia in Brugada syndrome: A systematic review and meta‐analysis |
| title_short | Long‐term of epicardial radiofrequency ablation and benefit for recurrent ventricular arrhythmia in Brugada syndrome: A systematic review and meta‐analysis |
| title_sort | long term of epicardial radiofrequency ablation and benefit for recurrent ventricular arrhythmia in brugada syndrome a systematic review and meta analysis |
| topic | Brugada syndrome epicardial radiofrequency ablation ICD shock long‐term outcomes ventricular arrhythmia |
| url | https://doi.org/10.1002/joa3.70073 |
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