title: Therapeutic hypothermia after out-of-hospital cardiac arrest due to Brugada syndrome.
abstract: A 56-year-old man was admitted to our hospital after successful resuscitation for out-of-hospital cardiac arrest. Electrocardiogram on admission showed right bundle branch block and ST segment elevation in leads V1-3. Subsequent intravenous infusion of isoproterenol rapidly resolved ST segment elevation, suggesting Brugada syndrome. Therapeutic hypothermia, that was performed with a target temperature of 34.0 degrees C did not induce ST segment elevation in leads V1-3. The J-ST segment elevation rather became much more normal, suggesting a beneficial effect of mild therapeutic hypothermia. Serial ECG showed the temporal variation of ST segment elevation, and pilsicainide challenge test showed the occurrence of ST segment elevation, confirming the diagnosis of Brugada syndrome. Clinical observation suggested that mild therapeutic hypothermia reversed the Brugada phenotype through the prevention of fever as well as being indicated for cerebral protection after cardiac arrest. In conclusion, therapeutic hypothermia with a temperature of 34.0 degrees C can be used safely in Brugada syndrome.
authors.affiliation: Department of Cardiology, Hiroshima City Hospital, 7-33, Moto-machi, Naka-ku, Hiroshima 730-8518, Japan. skurisu@nifty.com
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurisu
authors.forename: Ichiro
authors.initials: I
authors.lastname: Inoue
authors.forename: Takuji
authors.initials: T
authors.lastname: Kawagoe
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimatani
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nakama
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Maruhashi
authors.forename: Eisuke
authors.initials: E
authors.lastname: Kagawa
authors.forename: Kazuoki
authors.initials: K
authors.lastname: Dai
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Aokage
authors.forename: Junichi
authors.initials: J
authors.lastname: Matsushita
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikenaga
mesh_terms: D053840:Brugada Syndrome / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D012151:Resuscitation