Does Electrocardiographic Normalization Predict Successful Substrate Ablation in Brugada Syndrome?

landmark publication, the approach to substrate ablation of BrS rapidly evolved. Although multiple case reports and studies have supported the effectiveness of epicardial ablation, there are still several issues that need to be further investigated: the definition of local abnormal potentials for the ablation target, the procedural endpoint, the predictor of VF recurrence after the ablation procedure, and long-term follow-up data. The study by Mamiya et al 6 in this issue of the Journal is the first to systematically assess the ECG characteristics before and after ablation. The study demonstrated that ST-segment elevation and the number of abnormal spikes in the surface ECG were significantly decreased after epicardial substrate ablation. The improvements in ECG parameters were more significant in patients who had no

[1]  T. Murohara,et al.  Dynamic Changes in Electrocardiogram Parameters After Epicardial Substrate Catheter Ablation of Brugada Syndrome. , 2021, Circulation journal : official journal of the Japanese Circulation Society.

[2]  C. Morillo,et al.  2020 APHRS/HRS expert consensus statement on the investigation of decedents with sudden unexplained death and patients with sudden cardiac arrest, and of their families , 2020, Heart rhythm.

[3]  E. Behr,et al.  Mapping and Ablation of Ventricular Fibrillation Associated with Early Repolarization Syndrome. , 2019, Circulation.

[4]  J. Goldberger,et al.  Ablation strategies for the management of symptomatic Brugada syndrome: A systematic review. , 2018, Heart rhythm.

[5]  J. Brugada,et al.  Electrical Substrate Elimination in 135 Consecutive Patients With Brugada Syndrome , 2017, Circulation. Arrhythmia and electrophysiology.

[6]  K. Nademanee,et al.  Epicardial substrate ablation for Brugada syndrome. , 2017, Heart rhythm.

[7]  G. Fu,et al.  Characterization of the epicardial substrate for catheter ablation of Brugada syndrome. , 2016, Heart rhythm.

[8]  J. Brugada,et al.  Brugada Syndrome Phenotype Elimination by Epicardial Substrate Ablation , 2015, Circulation. Arrhythmia and electrophysiology.

[9]  Farhan M. Asrar,et al.  Quinidine, a life-saving medication for Brugada syndrome, is inaccessible in many countries. , 2013, Journal of the American College of Cardiology.

[10]  M. Field,et al.  Outcome After Implantation of a Cardioverter-Defibrillator in Patients With Brugada Syndrome: A Multicenter Study–Part 2 , 2006, Circulation.

[11]  Tachapong Ngarmukos,et al.  Prevention of Ventricular Fibrillation Episodes in Brugada Syndrome by Catheter Ablation Over the Anterior Right Ventricular Outflow Tract Epicardium , 2011, Circulation.

[12]  Prashanthan Sanders,et al.  Mapping and Ablation of Ventricular Fibrillation Associated With Long-QT and Brugada Syndromes , 2003, Circulation.

[13]  J. Brugada,et al.  Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report. , 1992, Journal of the American College of Cardiology.