ABSTRACT
Introduction
Mapping advances have expanded both the feasibility and benefits of ablation as a therapeutic approach, including in the treatment of two heart conditions that contribute to sudden cardiac death in young people: Brugada syndrome (BrS) and early repolarization syndrome (ERS). Although these conditions share a number of similarities, debates persist regarding the underlying pathophysiology and origin of the ventricular arrhythmias associated with them.
Areas covered
By synthesizing available data (PubMed), including current recommendations, pathophysiological insights and case reports, patient registries, our aim is to elucidate and establish the nuanced role of radiofrequency ablation (RFA) in therapeutic management.
Expert opinion
RFA is a particularly promising approach in BrS, with a proven long-term benefit. Concerning ERS, RFA seems to be interesting at the price of more complex procedures with more nuanced results.
Article highlights
Brugada Syndrome and Early Repolarization Syndrome share a number of pathophysiological mechanisms that explain their risk of ventricular arrhythmias.
Preventing recurrence of ventricular arrhythmias in challenging, with few of effective management measures aside from resorting to defibrillator implantation as a preventive measure against sudden death.
Improved mapping techniques have led to the development of radiofrequency ablation in BrS and ERS.
RFA is a promising therapeutic approach, particularly in Brugada syndrome where drug treatments remain limited and ineffective.
Abbreviations
BrS | = | Brugada syndrome |
ERP | = | Early Repolarization Pattern |
ERS | = | Early Repolarization Syndrome |
ICD | = | Implantable Cardioverter Defibrillator |
ECG | = | Electrocardiogram |
VT | = | Ventricular Tachycardia |
VF | = | Ventricular Fibrillation |
RV | = | Right Ventricle |
AP | = | Action Potential |
PVC | = | Premature Ventricular Contractions |
RVOT | = | Right Ventricular Outflow Tract |
RFA | = | Radiofrequency Ablation |
LV | = | Left Ventricle |
PES | = | Programed Electrical Stimulation |
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.