{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:54:15Z","timestamp":1792090455747,"version":"4.4.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T00:00:00Z","timestamp":1631145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008497","name":"Boston Scientific Corporation","doi-asserted-by":"publisher","award":["DE-08-16"],"award-info":[{"award-number":["DE-08-16"]}],"id":[{"id":"10.13039\/100008497","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"SNSF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Ajmaline challenge can unmask subcutaneous implantable cardioverter-defibrillator (S-ICD) screening failure in patients with Brugada syndrome (BrS) and non-diagnostic baseline electrocardiogram (ECG). The efficacy of the SMART Pass (SP) filter, a high-pass filter designed to reduce cardiac oversensing (while maintaining an appropriate sensing margin), has not yet been assessed in patients with BrS. The aim of this prospective multicentre study was to investigate the effect of the SP filter on dynamic Brugada ECG changes evoked by ajmaline and to assess its value in reducing S-ICD screening failure in patients with drug-induced Brugada ECGs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The S-ICD screening with conventional automated screening tool (AST) was performed during ajmaline challenge in subjects with suspected BrS. The S-ICD recordings were obtained before, during and after ajmaline administration and evaluated by the means of a simulation model that emulates the AST behaviour with and without SP filter. A patient was considered suitable for S-ICD if at least one sensing vector was acceptable in all tested postures. A sensing vector was considered acceptable in the presence of QRS amplitude &amp;gt;0.5\u2009mV, QRS\/T-wave ratio &amp;gt;3.5, and sense vector score &amp;gt;100. Of the 126 subjects (mean age: 42\u2009\u00b1\u200914\u2009years, males: 61%, sensing vectors: 6786), 46 (36%) presented with an ajmaline-induced Brugada type 1 ECG. Up to 30% of subjects and 40% of vectors failed the screening during the appearance of Brugada type 1 ECG evoked by ajmaline. The S-ICD screening failure rate was not significantly reduced in patients with Brugada ECGs when SP filter was enabled (30% vs. 24%). Similarly, there was only a trend in reduction of vector-failure rate attributable to the SP filter (from 40% to 36%). The most frequent reason for screening failure was low QRS amplitude or low QRS\/T-wave ratio. None of these patients was implanted with an S-ICD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Patients who pass the sensing screening during ajmaline can be considered good candidates for S-ICD implantation, while those who fail might be susceptible to sensing issues. Although there was a trend towards reduction of vector sensing failure rate when SP filter was enabled, the reduction in S-ICD screening failure in patients with Brugada ECGs did not reach statistical significance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical trial registration<\/jats:title>\n                  <jats:p>https:\/\/clinicaltrials.gov Unique Identifier NCT04504591.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euab230","type":"journal-article","created":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T19:12:05Z","timestamp":1628709125000},"page":"845-854","source":"Crossref","is-referenced-by-count":14,"title":["Impact of SMART Pass filter in patients with ajmaline-induced Brugada syndrome and subcutaneous implantable cardioverter-defibrillator eligibility failure: results from a prospective multicentre study"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2248-3456","authenticated-orcid":false,"given":"Giulio","family":"Conte","sequence":"first","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"},{"name":"Centre for Computational Medicine in Cardiology, Faculty of Informatics, Universit\u00e0 della Svizzera Italiana, Lugano, Switzerland"},{"name":"Faculty of Biomedical Sciences, USI, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9351-0760","authenticated-orcid":false,"given":"Carlo","family":"de Asmundis","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel\u2014Postgraduate program Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Berne","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ospedale San Francesco, Nuoro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Vicentini","sequence":"additional","affiliation":[{"name":"Elettrofisiologia ed Elettrostimolazione, Divisione di Cardiologia, IRCCS Policlinico S. Matteo, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Namdar","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital of Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Scalone","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ospedale Brotzu, Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Klersy","sequence":"additional","affiliation":[{"name":"Service of Biometry and Clinical Epidemiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luce","family":"Caputo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Demarchi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tardu","family":"\u00d6zkartal","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Salghetti","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel\u2014Postgraduate program Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavino","family":"Casu","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ospedale San Francesco, Nuoro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Passarelli","sequence":"additional","affiliation":[{"name":"Elettrofisiologia ed Elettrostimolazione, Divisione di Cardiologia, IRCCS Policlinico S. Matteo, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Mameli","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ospedale Brotzu, Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipen","family":"Shah","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital of Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4393-5338","authenticated-orcid":false,"given":"Haran","family":"Burri","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital of Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"De Ferrari","sequence":"additional","affiliation":[{"name":"Elettrofisiologia ed Elettrostimolazione, Divisione di Cardiologia, IRCCS Policlinico S. Matteo, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3172-6106","authenticated-orcid":false,"given":"Pedro","family":"Brugada","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel\u2014Postgraduate program Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2116-6993","authenticated-orcid":false,"given":"Angelo","family":"Auricchio","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"},{"name":"Centre for Computational Medicine in Cardiology, Faculty of Informatics, Universit\u00e0 della Svizzera Italiana, Lugano, Switzerland"},{"name":"Faculty of Biomedical Sciences, USI, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,9]]},"reference":[{"key":"2022050518233687400_euab230-B1","first-page":"1601","article-title":"ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the Europe","volume":"17","author":"Priori","year":"2015","journal-title":"Europace"},{"key":"2022050518233687400_euab230-B2","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1056\/NEJMoa1915932","article-title":"Subcutaneous or transvenous defibrillator therapy","volume":"383","author":"Knops","year":"2020","journal-title":"N Engl J Med"},{"key":"2022050518233687400_euab230-B3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1161\/CIRCULATIONAHA.120.048728","article-title":"Primary results from the understanding outcomes with the S-ICD in primary prevention patients with low ejection fraction (UNTOUCHED) trial","volume":"143","author":"Gold","year":"2020","journal-title":"Circulation"},{"key":"2022050518233687400_euab230-B4","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.jacc.2014.12.031","article-title":"Implantable cardioverter-defibrillator therapy in Brugada syndrome: a 20-year single-center experience","volume":"65","author":"Conte","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2022050518233687400_euab230-B5","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1161\/CIRCULATIONAHA.113.001941","article-title":"Outcome after implantation of a cardioverter-defibrillator in patients with Brugada syndrome: a multicenter study-part 2","volume":"128","author":"Sacher","year":"2013","journal-title":"Circulation"},{"key":"2022050518233687400_euab230-B6","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1093\/europace\/euw415","article-title":"Inappropriate shocks in single-chamber and subcutaneous implantable cardioverter-defibrillators: a systematic review and meta-analysis","volume":"19","author":"Auricchio","year":"2017","journal-title":"Europace"},{"key":"2022050518233687400_euab230-B7","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.hrthm.2020.11.013","article-title":"Subcutaneous versus transvenous implantable defibrillator: an updated meta-analysis","volume":"18","author":"Rordorf","year":"2021","journal-title":"Heart Rhythm"},{"key":"2022050518233687400_euab230-B8","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1016\/j.jacc.2015.02.047","article-title":"Safety and efficacy of the totally subcutaneous implantable defibrillator: 2-year results from a pooled analysis of the IDE study and EFFORTLESS Registry","volume":"65","author":"Burke","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2022050518233687400_euab230-B9","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1111\/jce.15059","article-title":"Predictors of inappropriate shock in Brugada syndrome patients with a subcutaneous implantable cardiac defibrillator","volume":"32","author":"Casu","year":"2021","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2022050518233687400_euab230-B10","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1111\/jce.12612","article-title":"A new algorithm to reduce inappropriate therapy in the S-ICD system","volume":"26","author":"Brisben","year":"2015","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2022050518233687400_euab230-B11","year":"2015"},{"key":"2022050518233687400_euab230-B12","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.ijcard.2015.05.082","article-title":"Sensitivity and specificity of the subcutaneous implantable cardioverter defibrillator pre-implant screening tool","volume":"195","author":"Zeb","year":"2015","journal-title":"Int J Cardiol"},{"key":"2022050518233687400_euab230-B13","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.ijcard.2018.07.037","article-title":"Evaluation of a novel automatic screening tool for determining eligibility for a subcutaneous implantable cardioverter-defibrillator","volume":"272","author":"Sakhi","year":"2018","journal-title":"Int J Cardiol"},{"key":"2022050518233687400_euab230-B14","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1093\/europace\/eux009","article-title":"High rate of subcutaneous implantable cardioverter-defibrillator sensing screening failure in patients with Brugada syndrome: a comparison with other inherited primary arrhythmia syndromes","volume":"20","author":"Conte","year":"2018","journal-title":"Europace"},{"key":"2022050518233687400_euab230-B15","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1093\/eurheartj\/ehv572","article-title":"Subcutaneous implantable cardioverter-defibrillator and drug-induced Brugada syndrome: the importance of repeat morphology analysis during ajmaline challenge","volume":"37","author":"Conte","year":"2016","journal-title":"Eur Heart J"},{"key":"2022050518233687400_euab230-B16","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.jacc.2016.05.058","article-title":"Brugada syndrome and the subcutaneous implantable cardioverter-defibrillator","volume":"68","author":"Olde Nordkamp","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2022050518233687400_euab230-B17","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.1093\/eurheartj\/ehz049","article-title":"Ajmaline infusion during automated screening in Brugada syndrome and spontaneous Type 1 electrocardiogram unmasks non-suitability for subcutaneous implantable cardioverter-defibrillator","volume":"40","author":"\u00d6zkartal","year":"2019","journal-title":"Eur Heart J"},{"key":"2022050518233687400_euab230-B18","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.repc.2020.11.004","article-title":"The variability of the electrocardiogram in Brugada syndrome: implications for subcutaneous implantable cardioverter-defibrillator candidacy","volume":"40","author":"Brugada","year":"2020","journal-title":"Rev Port Cardiol"},{"key":"2022050518233687400_euab230-B19","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.ijcard.2015.05.135","article-title":"Inappropriate shocks in the subcutaneous ICD: incidence, predictors and management","volume":"195","author":"Oide Nordkamp","year":"2015","journal-title":"Int J Cardiol"},{"key":"2022050518233687400_euab230-B20","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1016\/j.jacc.2015.02.047","article-title":"Safety and efficacy of the totally subcutaneous implantable defibrillator: 2-year results from a pooled analysis of the IDE study and EFFORTLESS Registry","volume":"65","author":"Burke","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2022050518233687400_euab230-B21","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1016\/j.jacc.2012.06.053","article-title":"The entirely subcutaneous implantable cardioverter-defibrillator: initial clinical experience in a large Dutch cohort","volume":"60","author":"Olde Nordkamp","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2022050518233687400_euab230-B22","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.hroo.2020.10.002","article-title":"Evaluation of subcutaneous implantable cardioverter-defibrillator performance in patients with ion channelopathies from the EFFORTLESS cohort and comparison with a meta-analysis of transvenous ICD outcomes","volume":"1","author":"Lambiase","year":"2020","journal-title":"Heart Rhythm"},{"key":"2022050518233687400_euab230-B23","doi-asserted-by":"crossref","first-page":"e006265","DOI":"10.1161\/JAHA.117.006265","article-title":"Low prevalence of inappropriate shocks in patients with inherited arrhythmia syndromes with the subcutaneous implantable defibrillator single center experience and long-term follow-up","volume":"6","author":"Rudic","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"2022050518233687400_euab230-B24","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1016\/j.hrthm.2018.05.011","article-title":"Prospective blinded evaluation of a novel sensing methodology designed to reduce inappropriate shocks by the subcutaneous implantable cardioverter-defibrillator","volume":"15","author":"Theuns","year":"2018","journal-title":"Heart Rhythm"},{"key":"2022050518233687400_euab230-B25","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1111\/pace.12802","article-title":"Left and right parasternal sensing for the S-ICD in adult congenital heart disease patients and normal controls","volume":"39","author":"Wilson","year":"2016","journal-title":"Pacing Clin Electrophysiol"},{"key":"2022050518233687400_euab230-B26","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1253\/circj.CJ-16-0153","article-title":"Right parasternal lead placement increases eligibility for subcutaneous implantable cardioverter defibrillator therapy in adults with congenital heart disease","volume":"80","author":"Okamura","year":"2016","journal-title":"Circ J"}],"container-title":["EP Europace"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/24\/5\/845\/43526353\/euab230.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/24\/5\/845\/43526353\/euab230.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T19:34:20Z","timestamp":1651779260000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/24\/5\/845\/6367886"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,9]]},"references-count":26,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,9,9]]},"published-print":{"date-parts":[[2022,5,3]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euab230","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,5,1]]},"published":{"date-parts":[[2021,9,9]]}}}