Low-dose isoproterenol for repetitive ventricular arrhythmia in patients with Brugada syndrome.
OBJECTIVE
Arrhythmic storm or repetitive ventricular arrhythmia (VA) has been occasionally observed in Brugada syndrome (BS). A beta-adrenergic stimulator [isoproterenol (ISP)] has been reported to suppress this arrhythmic storm in sporadic cases. Accordingly, we investigated the antiarrhythmic effects of ISP infusion in consecutive BS patients with arrhythmic storm or repetitive VA.


RESULTS
Seven BS patients with arrhythmic storm were studied. Intravenous ISP was administered as a bolus injection (1-2 microg), followed by continuous infusion (0.15 microg/min). Arrhythmic storm or repetitive VA was suppressed immediately after the bolus administration of ISP, which was followed by continuous infusion of low-dose ISP for 1-3 days. In all patients, ST-elevation decreased in right precordial leads. In six of the seven patients, VA subsided after the discontinuance of ISP. RR interval was shortened and ST-elevation in right precordial leads was decreased after ISP bolus injection. ST-elevation in right precordial leads remained decreased during continuous ISP infusion, whereas the RR interval returned to the control level.


CONCLUSIONS
Continuous administration of low-dose ISP may be effective for the suppression of repetitive VA occurrence in patients with BS.
Watanabe
Atsuyuki
A
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. wata2034@mx31.tiki.ne.jp
Fukushima Kusano
Kengo
K
Morita
Hiroshi
H
Miura
Daiji
D
Sumida
Wakako
W
Hiramatsu
Shigeki
S
Banba
Kimikazu
K
Nishii
Nobuhiro
N
Nagase
Satoshi
S
Nakamura
Kazufumi
K
Sakuragi
Satoru
S
Ohe
Tohru
T
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000328:Adult; D053840:Brugada Syndrome / Q000188:drug therapy*; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007545:Isoproterenol / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged
D000318:Adrenergic beta-Agonists; D002316:Cardiotonic Agents; D007545:Isoproterenol