title: Ventricular fibrillation in a patient with prominent J (Osborn) waves and ST segment elevation in the inferior electrocardiographic leads: a Brugada syndrome variant?
abstract: Recurrent ventricular fibrillation was observed in a 29-year-old Vietnamese man who did not exhibit structural heart disease. The patient's ECG showed prominent J (Osborn) waves and ST segment elevation in the inferior leads that were not associated with hypothermia, serum electrolyte disturbance, or myocardial ischemia. Rate-dependent change in the amplitude of J waves and ST segment elevation also were observed. An implantable cardioverter defibrillator (ICD) was implanted. Adjunctive treatment with amiodarone reduced J wave amplitude, preventing ventricular fibrillation and ICD shocks. Prominent J waves and ST segment elevation in the inferior leads may serve as an important diagnostic sign to detect high-risk individuals with a history of unexplained syncope. ICD implantation plus amiodarone is the treatment of choice.
authors.affiliation: Lankenau Hospital, Wynnewood, Pennsylvania, USA.
authors.forename: H
authors.initials: H
authors.lastname: Kalla
authors.forename: G X
authors.initials: GX
authors.lastname: Yan
authors.forename: R
authors.initials: R
authors.lastname: Marinchak
mesh_terms: D000328:Adult; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002940:Circadian Rhythm; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D012151:Resuscitation; D014693:Ventricular Fibrillation / Q000150:complications* / Q000503:physiopathology* / Q000517:prevention & control / Q000628:therapy
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone