title: Alternative approach for management of an electrical storm in Brugada syndrome:Importance of primary ablation within a narrow time window.
abstract: Placement of an implantable cardioverter-defibrillator (ICD) is the only powerful treatment modality for Brugada syndrome in patients presenting with ventricular fibrillation (VF). For those whose first presentation is an electrical storm, pharmacologic therapy is typically used to control VF followed by ICD implantation. We report an alternative approach whereby, before ICD implantation, emergency catheter ablation of the VF-triggering premature ventricular contraction (PVC) resulted in long-term VF-free survival. The results suggest that, because VF triggers appear in a narrow time window, ablation of the culprit PVCs that initiate VF before the index PVCs subside is a reasonable alternative approach.
authors.affiliation: Division of Cardiovascular Medicine, Faculty of Medicine, Tsukuba University, 1-1-1, Tennodai Tsukuba, Japan.
authors.forename: Ahmed Karim
authors.initials: AK
authors.lastname: Talib
authors.affiliation: Division of Cardiovascular Medicine, Faculty of Medicine, Tsukuba University, 1-1-1, Tennodai Tsukuba, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Yui
authors.affiliation: Division of Cardiovascular Medicine, Faculty of Medicine, Tsukuba University, 1-1-1, Tennodai Tsukuba, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kaneshiro
authors.affiliation: Division of Cardiovascular Medicine, Faculty of Medicine, Tsukuba University, 1-1-1, Tennodai Tsukuba, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Sekiguchi
authors.affiliation: Division of Cardiovascular Medicine, Faculty of Medicine, Tsukuba University, 1-1-1, Tennodai Tsukuba, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Nogami
authors.affiliation: Division of Cardiovascular Medicine, Faculty of Medicine, Tsukuba University, 1-1-1, Tennodai Tsukuba, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Aonuma
keywords: Brugada syndrome; Electrical storm; Trigger ablation; Ventricular fibrillation