scholarly journals Case report: Synergetic effect of ischaemia and increased vagal tone inducing ventricular fibrillation in a patient with Brugada syndrome

2020 ◽  
Vol 4 (4) ◽  
pp. 1-5
Author(s):  
Sophie C H Van Malderen ◽  
Carl J Schultz ◽  
Luc Jordaens
Keyword(s):  
Ventricular Tachycardia ◽  
Case Report ◽  
Brugada Syndrome ◽  
Cardiac Death ◽  
Synergetic Effect ◽  
Vagal Tone ◽  
Cardioverter Defibrillator ◽  
Case Summary ◽  
Malignant Ventricular Arrhythmia ◽  
Proximal Right Coronary Artery

Abstract Background Brugada syndrome (BS) is a hereditary channelopathy associated with syncope, malignant ventricular arrhythmia, and sudden cardiac death. Right ventricular ischaemia and BS have similar underlying substrates precipitating ventricular tachycardia or fibrillation (VF). Case summary A 72-year-old woman with BS and a stenosis on the proximal right coronary artery received several subsequent implantable cardioverter-defibrillator shocks due to VF during an episode of extreme nausea with vomiting. Discussion This case report emphasizes on the synergetic effect of mild ischaemia and increased vagal tone on the substrate responsible for BS to create pathophysiological changes precipitating VF.

scholarly journals Fever Unmasked Brugada Syndrome in Pediatric Patient: A Case Report

2020 ◽  
Vol 4 (2) ◽  
pp. 244-246
Author(s):  
Orhay Mirzapolos ◽  
Perry Marshall ◽  
April Brill
Keyword(s):  
Emergency Medicine ◽  
Case Report ◽  
Brugada Syndrome ◽  
Ventricular Arrhythmias ◽  
Cardiac Monitoring ◽  
St Segment Elevation ◽  
Cardioverter Defibrillator ◽  
St Segment ◽  
Viral Illness ◽  
Automatic Implantable Cardioverter Defibrillator

Introduction: Brugada syndrome is an arrhythmogenic disorder that is a known cause of sudden cardiac death. It is characterized by a pattern of ST segment elevation in the precordial leads on an electrocardiogram (EKG) due to a sodium channelopathy. Case Report: This case report highlights the case of a five-year-old female who presented to the emergency department with a febrile viral illness and had an EKG consistent with Brugada syndrome. Discussion: Fever is known to accentuate or unmask EKG changes associated with Brugada due to temperature sensitivity of the sodium channels. Conclusion: Febrile patients with Brugada are at particular risk for fatal ventricular arrhythmias and fevers should be treated aggressively by the emergency medicine provider. Emergency medicine providers should also consider admitting febrile patients with Brugada syndrome who do not have an automatic implantable cardioverter-defibrillator for cardiac monitoring.

scholarly journals Brugada Syndrome: Presentation and Management of the Atypical Patient in the Emergent Setting

2020 ◽  
Vol 4 (2) ◽  
pp. 251-254
Author(s):  
Alexander Nguyen ◽  
Mario Flores ◽  
Vilmogil Tano
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Sudden Cardiac Death ◽  
Brugada Syndrome ◽  
Cardiac Death ◽  
Genetic Disorder ◽  
Atypical Presentation ◽  
Electrical System ◽  
Southeast Asians ◽  
Hispanic Male

Introduction: Brugada syndrome is a genetic disorder of the heart’s electrical system that increases a patient’s risk of sudden cardiac death. It is a syndrome most prevalent in Southeast Asians and is found 36 times more commonly in Asians than in Hispanics. Case Report: We report and discuss a case of a 68-year-old Hispanic male who presented with clinical and electrocardiogram abnormalities consistent with Brugada syndrome. Discussion: The patient’s age and ethnicity represents an atypical presentation of this rare syndrome and the lack of reported studies in the literature pertaining to these demographics reflect this. Conclusion: Further studies and characterizations are necessary as manifestations continue to be unearthed. As such, Brugada Syndrome should be considered in the differential diagnosis for a myriad of patient populations.

Ventricular tachycardia and sudden cardiac death might complicate the long-term outcome by patients after tetralogy of Fallot repair

2008 ◽  
Vol 149 (23) ◽  
pp. 1067-1069
Author(s):  
Attila Mihálcz ◽  
Csaba Földesi ◽  
Tamás Szili-Török
Keyword(s):  
Ventricular Tachycardia ◽  
Sudden Cardiac Death ◽  
Tetralogy Of Fallot ◽  
Cardiac Death ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cardioverter Defibrillator ◽  
Tetralogy Of Fallot Repair

A Fallot-tetralógia miatti műtétet követően a hosszú távú túlélést befolyásoló tényezők közé tartozik a kamrai tachycardia és a hirtelen szívhalál. E betegek gondozásában érdemi segítséget jelent az implantálható cardioverter defibrillátor rendszer. A végleges pacemaker és/vagy implantálható cardioverter defibrillátor implantációját követően ritka, ám potenciálisan letális kimenetelű fertőzéses szövődmény az endocarditis. Ez esetben a leghatékonyabb kezelési mód a kombinált terápia, amely a beültetett készülék + elektródák teljes körű eltávolításából és agresszív antibiotikus kezelésből áll. Célkitűzés: Ilyen esetekben a tervezett reimplantáció különös óvatosságot igényel a nagyobb recidívaarány miatt, amelynek rizikója fokozottabb pacemakerdependencia esetén. Célunk olyan módszer alkalmazása volt, amelynek segítségével a recidíva kockázata minimálisra csökkenthető. Módszer: Esetünkben a korábban Fallot-tetralógia miatt többször műtött, pacemaker-, majd implantálható cardioverter defibrillátor beültetéseken átesett betegnél recidív endocarditis miatt készülék- és elektródaeltávolítást végeztünk, standard antibiotikus terápia alkalmazásával. A reimplantációt minithoracotomián keresztül végeztük. Az így elhelyezett sokkelektróda elégtelen működése miatt egy másik sokkelektródát szubkután vezettünk a hátsó mellkasfali régióba; rendszerünk az indukált kamrafibrillációt sikerrel szüntette meg. Megbeszélés: Esetismertetésünk demonstrálja a szubkután defibrillátorrendszer alkalmazhatóságát és előnyeit speciális körülmények fennállásakor. Felhívjuk a figyelmet arra a tényre, hogy ezt a technikát gyakrabban is lehetne alkalmazni olyan esetekben, amelyekben a transzvénás implantáció nem optimális.

scholarly journals Brugada syndrome: an implantable cardioverter defibrillator for everyone? Case report

2014 ◽  
Vol 9 (9-10) ◽  
pp. 365-365
Author(s):  
Damir Raljevic ◽  
Aleksandra Sustar ◽  
Irena Kuzet Miokovic ◽  
Zeljko Madzar ◽  
Davorka Zagar ◽  
...  
Keyword(s):  
Case Report ◽  
Implantable Cardioverter Defibrillator ◽  
Brugada Syndrome ◽  
Cardioverter Defibrillator

scholarly journals A wearable cardioverter defibrillator for prevention of sudden cardiac death in a hematologic patient—a case report

2019 ◽  
Vol 12 (3) ◽  
pp. 269-271
Author(s):  
Stefan Hatzl ◽  
Hildegard T. Greinix ◽  
Philipp Kreuzer ◽  
Eduard Schulz ◽  
Peter Neumeister ◽  
...  
Keyword(s):  
Case Report ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Cardioverter Defibrillator ◽  
Wearable Cardioverter Defibrillator

Ventricular tachycardia underdetection by an ICD. When and how to change the wavelet default settings?

2017 ◽  
Vol 4 (45) ◽  
pp. 26-29
Author(s):  
Sławomir Tłuczek ◽  
Janusz Romanek ◽  
Andrzej Przybylski
Keyword(s):  
Heart Failure ◽  
Ventricular Tachycardia ◽  
Primary Prevention ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Wavelet Function ◽  
Supraventricular Arrhythmias ◽  
Detection Zone ◽  
Cardioverter Defibrillator

A 69-year-old patient with a single chamber cardioverter defibrillator (ICD) implanted in primary prevention of sudden cardiac death (heart failure in dilated cardiomyopathy) was admitted to the hospital due to ventricular tachycardia (VT) not recognized by the ICD. After control of ICD, it was concluded that the cause of the absence of ICD intervention was the classification of arrhythmia by Wavelet as a supraventricular. Default settings have been used since the implant – (Wavelet – 70%, Onset and Stability off). The arrhythmia was within the VT detection zone. There were two possible solutions: turning Wavelet off or reducing its threshold. However, considering the absence of supraventricular arrhythmias, the Wavelet function was disabled.

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