Dynamic electrocardiographic changes after aborted sudden death in a patient with Brugada syndrome and rate-dependent right bundle branch block.
A 37-year-old man with Brugada syndrome and dynamic changes of the ST-segment morphology observed after an episode of aborted sudden death is described. On admission, after 3 syncopal episodes during nighttime, his electrocardiogram showed right bundle branch block (RBBB) with a J-point elevation of 0.6 mV in lead V 2 . Changes observed in the following days included a diminished J-point elevation and intermittent "saddle-back" type of morphology. During a previous 2-year follow-up, intermittent, complete, acceleration-dependent RBBB was documented. Right ventricular intracavitary tracings showed an RS pattern with a broad S wave in the unipolar electrogram; the time of onset of intrinsic deflection in this electrogram was 60 milliseconds. To our knowledge, this is the first report of an intracavitary demonstration of complete RBBB in Brugada syndrome.
Márquez
Manlio F
MF
Department of Electrocardiology, Instituto Nacional de Cardiología Ignacio Chávez, Tlalpan 14080, Mexico City, Mexico. manliomarquez@yahoo.com
Bisteni
Abdo
A
Medrano
Gustavo
G
De Micheli
Alfredo
A
Guevara
Milton
M
Iturralde
Pedro
P
Colín
Luis
L
Hermosillo
Antonio G
AG
Cárdenas
Manuel
M
D000328:Adult; D001146:Arrhythmia, Sinus / Q000209:etiology; D001919:Bradycardia / Q000209:etiology; D002037:Bundle-Branch Block / Q000150:complications* / Q000628:therapy; D017147:Defibrillators, Implantable; D004562:Electrocardiography / Q000145:classification / Q000379:methods; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000628:therapy*; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D013575:Syncope / Q000209:etiology; D013577:Syndrome