Evidence mapPaperPMID 40401314Full record

Trial reportEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025

Epicardial ablation in high-risk Brugada syndrome to prevent ventricular fibrillation: results from a randomized clinical trial.

Carlo Pappone, Giuseppe Ciconte, Gabriele Vicedomini, Emanuele Micaglio, Antonio Boccellino, Gabriele Negro, Luigi Giannelli, Roberto Rondine, Pasquale Creo, Adriana Tarantino and 9 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03294278 (Epicardial Ablation in Brugada Syndrome in the Prevention of Sudden Cardiac Death. A Randomized Prospective Follow-up Study.), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03294278 naunknown statusnot on this map

Epicardial Ablation in Brugada Syndrome in the Prevention of Sudden Cardiac Death. A Randomized Prospective Follow-up Study.

TypeinterventionalSponsorIRCCS Policlinico S. DonatoRan2017 to 2023Enrolled150ConditionsVentricular Arrhythmias and Cardiac ArrestArmsablation plus ICD
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Accumulating evidence for epicardial ablation in malignant forms of Brugada syndrome: summary of two randomized clinical trials.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Carlo PapponeArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.ORCID 0000-0002-0901-6135
Giuseppe CiconteArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.ORCID 0000-0001-7886-5467
Gabriele VicedominiArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.
Emanuele MicaglioArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.ORCID 0000-0002-8298-7800
Antonio BoccellinoArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.ORCID 0000-0003-3406-2675
Gabriele NegroArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.ORCID 0000-0003-1531-3504
Luigi GiannelliArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.ORCID 0000-0001-8141-9476
Roberto RondineArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.ORCID 0000-0002-7143-8902
Pasquale CreoInstitute of Molecular and Translational Cardiology (IMTC), Piazza Malan 2, 20097, San Donato Milanese, Milan, Italy.ORCID 0000-0003-1545-3427
Adriana TarantinoInstitute of Molecular and Translational Cardiology (IMTC), Piazza Malan 2, 20097, San Donato Milanese, Milan, Italy.ORCID 0000-0002-1859-130X
Marco BallarottoArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.
Vincenzo MaioloArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.ORCID 0009-0004-2543-8583
Cristiano CiaccioArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.
Roberto ManuelloArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.ORCID 0009-0005-7028-4533
Emanuela T LocatiArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.ORCID 0000-0002-4488-0455
Beniamino C MazzaArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.ORCID 0000-0002-8976-6568
Mattia VecchiArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.
Žarko ĆalovićArrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, Piazza E. Malan 1, San Donato Milanese, 20097 Milano, Italy.ORCID 0000-0002-3267-9850
Luigi AnastasiaSchool of Medicine, University Vita-Salute San Raffaele, Via Olgettina, 58, 20132 Milan, Italy.ORCID 0000-0002-0712-2161

Funding

IRCCS Policlinico San DonatoItalian Ministry of Health
6 · The paper itself

Abstract

aimsEpicardial ablation for Brugada syndrome (BrS) has shown promise in reducing ventricular fibrillation (VF), but its role remains controversial due to the lack of randomized trials. This study evaluates the efficacy of catheter ablation in high-risk BrS patients. METHODS AND

resultsThis prospective, single-centre, randomized (2:1) study enrolled BrS patients with cardiac arrest (CA) or appropriate ICD therapies. All patients had an ICD and were randomized to undergo epicardial ablation (ablation group) or no ablation (control group). Enrolment began in September 2017 and prematurely terminated in February 2024. The primary endpoint was freedom from VF recurrences. Secondary endpoints included procedure safety, ICD-related complications, and quality-of-life assessment. Forty patients (83% male, mean age 43.7 ± 12.1) were randomized: 26 in the ablation group and 14 in the control group. Thirty-six patients received appropriate ICD therapies before enrolment: 24 (92%) in the ablation group and 12 (86%) in the control group. One patient in the ablation group experienced a post-procedural pericardial effusion requiring pericardiocentesis. Thirteen patients (33%) had major ICD-related complications. After a mean follow-up of 4.0 ± 1.7 years, freedom from VF recurrence was 96% (25/26) in the ablation group and 50% (7/14) in the control group (P < 0.001). No unexplained or arrhythmic deaths occurred during follow-up.

conclusionEpicardial catheter ablation was associated with a reduction in VF recurrence compared with ICD therapy alone. These findings support the use of epicardial ablation in high-risk BrS patients. CLINICALTRIALS.GOV: ID NCT03294278.

Indexed as

Brugada SyndromeCatheter AblationPericardiumVentricular FibrillationAdultDefibrillators, ImplantableFemaleHumansMaleMiddle AgedProspective StudiesQuality of LifeRecurrenceRisk FactorsTreatment OutcomeArrhythmogenic substrateBrugada syndromeCardiac arrestEpicardiumICDVentricular fibrillation

Identifiers

PMID40401314
PMCPMC12096002

What Socratic holds

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LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.