[Recurrent ventricular fibrillation during a febrile illness in a patient with the Brugada syndrome].
Different situations have been involved in the origin of ventricular arrhythmic events in patients with the Brugada syndrome such as bradycardia, alcohol consumption and mental stress. We present a 30 year old male with recurrent ventricular fibrillation due to a febrile illness with intense sweating. He had been previously studied at our Unit in 1995 because of an episode of resuscitated cardiac arrest due to ventricular fibrillation. The twelve-lead electrocardiogram showed the typical characteristics of a patient with the Brugada syndrome. Different invasive and non-invasive tests performed were normal. He received a defibrillator and had no recurrences during 4 years of follow up. In March,1999, after an upper respiratory tract infection he had high fever treated with paracetamol but at down he had sweating and chills, followed by 3 defibrillator shocks. Late interrogation showed 5 episodes of ventricular fibrillation, two of them non-sustained, and the rest adequately treated by the defibrillator. Activation and inactivation kinetics for early INa are twofold faster at higher temperature, and shift activation and steady-state inactivation. This may explain the role of the temperature as a trigger for ventricular arrhythmias in our patient.
González Rebollo
J M
JM
Unidad de Arritmias, Hospital Ramón y Cajal, Departamento de Medicina, Universidad de Alcalá, Madrid.
Hernández Madrid
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A
García
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García de Castro
A
A
Mejías
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A
Moro
C
C
D000328:Adult; D005334:Fever / Q000150:complications*; D006801:Humans; D008297:Male; D012008:Recurrence; D013575:Syncope / Q000150:complications*; D013577:Syndrome; D014693:Ventricular Fibrillation / Q000209:etiology*