Electrical storm in Brugada syndrome successfully treated with orciprenaline; effect of low-dose quinidine on the electrocardiogram.
We report a case of an electrical storm occurring in a patient implanted with a cardioverter defibrillator for symptomatic Brugada syndrome. Recurrent ventricular fibrillation was initiated by short-coupled premature ventricular beats of right ventricular origin, associated with a fixed Brugada type 2 electrocardiographic pattern. Low-dose orciprenaline application as an intravenous bolus followed by an infusion inhibited the recurrence of ventricular fibrillation and normalized the electrocardiographic pattern. Low-dose oral quinidine had only a moderate effect on the ST-elevation.
Kyriazis
Konstantinos
K
Asklepios Hospital St. Georg, Department of Cardiology, Lohmühlenstrasse 5, 20099 Hamburg, Germany. kyriazis_k@yahoo.com
Bahlmann
Edda
E
van der Schalk
Hendrik
H
Kuck
Karl-Heinz
KH
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D053840:Brugada Syndrome / Q000628:therapy*; D017147:Defibrillators, Implantable; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009921:Metaproterenol / Q000627:therapeutic use*; D011802:Quinidine / Q000627:therapeutic use*; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000188:drug therapy* / Q000503:physiopathology*
D000889:Anti-Arrhythmia Agents; D009921:Metaproterenol; D011802:Quinidine