{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:03:18Z","timestamp":1788498198055,"version":"build-2803163510"},"reference-count":51,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background: Catheter ablation of the arrhythmogenic substrate has emerged as a promising therapeutic strategy for symptomatic Brugada syndrome (BrS). However, high-quality comparative evidence against conventional implantable cardioverter-defibrillator (ICD)-based management remains limited. Objectives: This meta-analysis aimed to evaluate the efficacy of catheter ablation in reducing ventricular fibrillation (VF) recurrence in symptomatic BrS compared to standard therapy. Methods: Medline, Cochrane Library, and Scopus were systematically searched through 1 June 2025. Study selection, data extraction, and quality assessment were independently conducted by three reviewers. Random-effects meta-analyses were used to pool risk estimates. Results: Three studies (two randomized controlled trials, one observational cohort; 130 symptomatic BrS patients) were included. Over a median follow-up of 3.9 years, catheter ablation was associated with a significantly lower risk of VF recurrence compared to standard therapy [risk ratio (RR) = 0.19, 95% confidence interval (CI) = (0.06, 0.60); I2 = 36%, p for heterogeneity = 0.21], with no deaths reported in any group. A sensitivity analysis restricted to randomized trials confirmed similar findings in favor of ablation. Conclusions: Catheter ablation was associated with reduced VF recurrence compared to ICD therapy alone, supporting its potential role as first-line treatment in symptomatic BrS or as an alternative for patients who decline ICD implantation.<\/jats:p>","DOI":"10.3390\/medsci13030115","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T10:13:51Z","timestamp":1754475231000},"page":"115","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Catheter Ablation vs. Standard Implantable Cardioverter Defibrillator Therapy in Symptomatic Brugada Syndrome: A Systematic Review and Meta-Analysis of Controlled Studies"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3561-5713","authenticated-orcid":false,"given":"Paschalis","family":"Karakasis","sequence":"first","affiliation":[{"name":"Second Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9260-6306","authenticated-orcid":false,"given":"Panagiotis","family":"Theofilis","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5411-6461","authenticated-orcid":false,"given":"Konstantinos","family":"Pamporis","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6604-5581","authenticated-orcid":false,"given":"Antonios P.","family":"Antoniadis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7158-4950","authenticated-orcid":false,"given":"Nikolaos","family":"Fragakis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2514","DOI":"10.1161\/01.CIR.0000034169.45752.4A","article-title":"Proposed diagnostic criteria for the Brugada syndrome: Consensus report","volume":"106","author":"Wilde","year":"2002","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1161\/01.CIR.0000152479.54298.51","article-title":"Brugada syndrome: Report of the second consensus conference: Endorsed by the Heart Rhythm Society and the European Heart Rhythm Association","volume":"111","author":"Antzelevitch","year":"2005","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3997","DOI":"10.1093\/eurheartj\/ehac262","article-title":"2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death","volume":"43","author":"Zeppenfeld","year":"2022","journal-title":"Eur. 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