Drug-induced Brugada syndrome.
Survivors of sudden death without structural heart disease and a normal coronary angiogram are often diagnosed with idiopathic ventricular fibrillation (VF). The criteria for idiopathic VF have been reviewed elsewhere. However, a careful analysis of the electrocardiogram (ECG) is essential in the differential diagnosis of unexplained sudden cardiac death. We report two patients with unexplained VF, intermittent right bundle-branch block (RBBB) and ST-segment elevation in the precordial leads V1-V3. This syndrome is named after Brugada who first described a clinical series. This paper stresses the dynamic changes and the spontaneous normalization of the ECG. Class I drugs can unmask this peculiar ECG-pattern and can sometimes precipitate an arrhythmia if they are given chronically. Patients with the diagnosis of idiopathic VF should be screened for intermittent RBBB and ST-segment elevation. Because the syndrome is mostly familial and inherited as an autosomal dominant trait, diagnosis of this entity in a patient has an implication for the screening of family members.
Goethals
P
P
Department of Cardiology, Algemeen Ziekenhuis Sint-Jan, Brussels, Belgium.
Debruyne
P
P
Saffarian
M
M
D000368:Aged; D002037:Bundle-Branch Block / Q000150:complications / Q000175:diagnosis; D016757:Death, Sudden, Cardiac; D004562:Electrocardiography; D006323:Heart Arrest / Q000175:diagnosis / Q000209:etiology; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D013575:Syncope / Q000209:etiology; D013577:Syndrome; D014693:Ventricular Fibrillation / Q000150:complications / Q000175:diagnosis