title: Efficacy of pulmonary vein isolation in paroxysmal atrial fibrillation patients with a Brugada electrocardiogram.
abstract: BACKGROUND
  Medical therapy of atrial fibrillation (AF) can be challenging in patients with Brugada electrocardiograms (ECGs). The purpose of this study was to investigate the efficacy of pulmonary vein (PV) isolation (PVI) in AF patients with Brugada ECGs.
  
  
  RESULTS
  PVI was performed in 6 consecutive patients exhibiting Brugada ECGs (type I in 1, type II in 4, and type III in 1) at baseline. In all patients exhibiting type II or III Brugada ECGs but 1, the administration of sodium-channel blockers converted those ECG patterns to a type I. Five of 6 (83%) patients were free of symptomatic AF without any antiarrhythmic drugs after the first procedure. In the 1 remaining patient with AF recurrence and newly developed atrial tachycardia (AT), the residual conduction gaps of the 3 previously isolated PVs and a focal AT originating from the mitral isthmus were eliminated in the 2nd session. Finally, during the follow-up period (11+/-6 months) after the last procedure, all patients were free of any symptomatic atrial arrhythmias without any antiarrhythmic drugs. No other complications occurred.
  
  
  CONCLUSIONS
  Because of the concerns of proarrhythmias with antiarrhythmic drugs, PVI may be an effective strategy for highly symptomatic patients with AF who have a Brugada ECG pattern.
authors.affiliation: Division of Cardiovascular Diseases, University of Alabama at Birmingham, 1670 University Boulevard, 15303rd AVE S, Birmingham, AL 35294-0019, USA. takumi-y@fb4.so-net.ne.jp
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamada
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Naoya
authors.initials: N
authors.lastname: Tsuboi
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Murakami
authors.forename: Taro
authors.initials: T
authors.lastname: Okada
authors.forename: Hugh T
authors.initials: HT
authors.lastname: McElderry
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshida
authors.forename: Harish
authors.initials: H
authors.lastname: Doppalapudi
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Epstein
authors.forename: Vance J
authors.initials: VJ
authors.lastname: Plumb
authors.forename: Yasuya
authors.initials: Y
authors.lastname: Inden
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
authors.forename: G Neal
authors.initials: GN
authors.lastname: Kay
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D053840:Brugada Syndrome / Q000150:complications / Q000628:therapy*; D017115:Catheter Ablation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins; D026941:Sodium Channel Blockers / Q000008:administration & dosage*
chemical_list: D000889:Anti-Arrhythmia Agents; D026941:Sodium Channel Blockers