title: Near fatal ventricular fibrillation in Brugada syndrome despite presence of an implanted implantable cardioverter defibrillator.
abstract: A 38-year-old man with Brugada syndrome and aborted cardiac arrest was treated with quinidine only, based on the results of electrophysiologic drug testing. Six months later, after suffering a vaso-vagal syncope, he opted to receive an implantable cardioverter defibrillator and decided to discontinue quinidine against our recommendation. Sixty-seven months later, he had recurrent ventricular fibrillation that was terminated only by the sixth maximal energy shock delivered by the device (which has the capability to deliver a maximum of 8 shocks). This case suggests the possible risk in only relying on an implantable cardioverter defibrillator in the management of cardiac arrest survivors with Brugada syndrome.
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel-Aviv and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: bblhass@tasmc.health.gov.il.
authors.forename: Bernard
authors.initials: B
authors.lastname: Belhassen
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel-Aviv and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Sami
authors.initials: S
authors.lastname: Viskin
mesh_terms: D000328:Adult; D053840:Brugada Syndrome / Q000150:complications* / Q000628:therapy; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D014693:Ventricular Fibrillation / Q000150:complications / Q000628:therapy*