Short-term normalization of ventricular repolarization by transcatheter ablation in a patient with suspected Brugada Syndrome

详细信息    查看全文

• 作者：Qijun Shan ; Bing Yang ; Minglong Chen ; Jiangang Zou ; Chun Chen ; Dongjie Xu and Kejiang Cao
• 关键词：Brugada syndrome ; Sudden death ; Catheter ablation ; Propafenone ; Ventricular repolarization
• 刊名：Journal of Interventional Cardiac Electrophysiology
• 出版年：2008
• 出版时间：January, 2008
• 年：2008
• 卷：21
• 期：1
• 页码：53-57
• 全文大小：337.0 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  
• 出版者：Springer Netherlands
• ISSN：1572-8595

文摘

We report a 30 year old male without structural heart disease who presented with recurrent nocturnal syncope and aborted sudden cardiac death. 12-lead ECG showed elevated ST in inferior leads and short coupled premature ventricular complexes (PVCs). Propafenone challenge suggested a diagnosis of an atypical Brugada syndrome. Two morphological types of PVCs and ventricular fibrillation (VF) were induced during propafenone challenge test. He underwent two ablation procedures in right ventricular inflow tract and left ventricular post-inferior septum region by pace-mapping, respectively. After ablation, VF could not be induced and the elevated ST segments normalized. Two subsequent propafenone challenge tests were also negative. Nonetheless, elevated ST segments and PVCs reappeared by 1 month follow-up. An implantable defibrillator was recommended, but the patient declined for financial reasons. Unfortunately, he suffered a sudden cardiac death at home 10 weeks post-ablation. These findings suggest that short-term normalization of ventricular repolarization possibly due to radiofrequency ablation may occur in Brugada syndrome. However, the transient nature of this finding suggests that it is not a reliable indicator of protection against sudden cardiac death.