title: [Brugada syndrome associated with ventricular fibrillation induced by administration of pilsicainide: a case report].
abstract: A 56-year-old man with Brugada syndrome presented with ventricular fibrillation induced by administration of pilsicainide. He had syncope at age 46 years, and his uncle suddenly died of unknown cause. He had taken pilsicainide (150 mg/day) for paroxysmal atrial fibrillation, and suffered from syncope due to ventricular fibrillation. Coved type ST elevation was observed in the V1 lead, and saddle back type ST elevation was observed in the V2 lead. The ST elevation gradually recovered after stopping pilsicainide therapy. No structural heart disease was found. After intravenous injection of pilsicainide, the ST segment elevated in the V1 and V2 leads. Ventricular fibrillation was induced by triple extrastimulation at the right ventricular apex. The diagnosis was Brugada syndrome, and a cardioverter-defibrillator was implanted. Brugada syndrome should be considered before administering pilsicainide.
authors.affiliation: Second Department of Internal Medicine, Yokohama City University, School of Medicine, Fukuura 3-9, Kanazawa-ku, Yokohama 236-0004.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Sumita
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Kohei
authors.initials: K
authors.lastname: Matsushita
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohkusu
authors.forename: Yohei
authors.initials: Y
authors.lastname: Yamakawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Ichiroh
authors.initials: I
authors.lastname: Nakazawa
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Mochida
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ebina
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Uchino
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology; D004562:Electrocardiography; D004594:Electrophysiology; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects* / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D014693:Ventricular Fibrillation / Q000139:chemically induced* / Q000503:physiopathology
chemical_list: D000889:Anti-Arrhythmia Agents; D008012:Lidocaine; C042288:pilsicainide