Right coronary cusp as a new window of ablation for pilsicainide-induced ventricular premature contractions in a patient with Brugada syndrome.
A previous study demonstrated that ventricular premature contractions (VPCs) and ventricular fibrillation (VF) are provoked during sodium channel blocker challenge tests in Brugada syndrome (BrS) patients (Morita et al., J Am Coll Cardiol 42:1624-1631, 2003). The right ventricular outflow tract (RVOT) is a major arrhythmogenic focus and isolated VPCs originating from that area have been shown to initiate VF (Kakishita et al., J Am Coll Cardiol 36:1646-1653, 2000). Here, we describe a case report of a BrS patient with VPCs arising from the posterior aspect of the RVOT epicardium which was provoked by a low-dose of pilsicainide, a pure sodium channel blocker, and was successfully ablated from the right coronary cusp.
Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. hyamasaki@mail.goo.ne.jp.
Hiro
H
Yamasaki
Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan.
Hiroshi
H
Tada
Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Yukio
Y
Sekiguchi
Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Kazutaka
K
Aonuma
D000328:Adult; D053840:Brugada Syndrome / Q000188:drug therapy*; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006352:Heart Ventricles / Q000187:drug effects*; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects / Q000031:analogs & derivatives*; D008297:Male; D010496:Pericardium / Q000503:physiopathology; D026941:Sodium Channel Blockers / Q000009:adverse effects*; D018879:Ventricular Premature Complexes / Q000139:chemically induced / Q000175:diagnosis* / Q000601:surgery
D026941:Sodium Channel Blockers; D008012:Lidocaine; C042288:pilsicainide
Brugada syndrome; Ventricular premature contractions