title: Action potential alternans in the right ventricular outflow tract in a patient with asymptomatic Brugada syndrome.
abstract: A 71-year-old man with frequent ventricular premature contractions after right hip joint surgery was referred to the Cardiology Division. Twelve-lead ECG showed type II Brugada-type ECG and signal-averaged ECG showed positive ventricular late potentials. The 12-lead ECG changed to type I Brugada-type after administration of the class Ic antiarrhythmic drug, pilsicainide. Ventricular fibrillation (VF) was reproducibly induced with double premature stimuli from the right ventricular outflow tract (RVOT) at a basic cycle length (BCL) of 400 ms. Monophasic action potentials (MAPs) recorded from the RVOT at a BCL of 400 ms showed MAP alternans and VF was only induced when extrastimuli were applied after a shorter MAP of the alternans.
authors.affiliation: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kofune
authors.forename: Ichiro
authors.initials: I
authors.lastname: Watanabe
authors.forename: Sonoko
authors.initials: S
authors.lastname: Ashino
authors.forename: Kimie
authors.initials: K
authors.lastname: Ohkubo
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Okumura
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kofune
authors.forename: Toshiko
authors.initials: T
authors.lastname: Nakai
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
mesh_terms: D000200:Action Potentials / Q000187:drug effects / Q000502:physiology*; D000368:Aged; D000889:Anti-Arrhythmia Agents; D053840:Brugada Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D004562:Electrocardiography; D006801:Humans; D008012:Lidocaine / Q000031:analogs & derivatives; D008297:Male; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000503:physiopathology; D016278:Ventricular Function, Right / Q000502:physiology*
chemical_list: D000889:Anti-Arrhythmia Agents; D008012:Lidocaine; C042288:pilsicainide