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

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.

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Mode of Onset of Ventricular Fibrillation in Patients With Brugada Syndrome Detected by Implantable Cardioverter Defibrillator Therapy. Kakishita M, Kurita T, Matsuo K, et al. J Am Coll Cardiol 2000;36:1646–53

ACC Current Journal Review ◽

10.1016/s1062-1458(01)00190-8 ◽

2001 ◽

Vol 10 (2) ◽

pp. 64

Keyword(s):

Ventricular Fibrillation ◽

Implantable Cardioverter Defibrillator ◽

Brugada Syndrome ◽

Implantable Cardioverter Defibrillator Therapy ◽

Cardioverter Defibrillator

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Exercise stress test reveals ineligibility for subcutaneous implantable cardioverter defibrillator in patients with Brugada syndrome

Journal of Cardiovascular Electrophysiology ◽

10.1111/jce.13315 ◽

2017 ◽

Vol 28 (12) ◽

pp. 1454-1459 ◽

Cited By ~ 9

Author(s):

Motomi Tachibana ◽

Nobuhiro Nishii ◽

Hiroshi Morita ◽

Koji Nakagawa ◽

Atsuyuki Watanabe ◽

...

Keyword(s):

Implantable Cardioverter Defibrillator ◽

Brugada Syndrome ◽

Stress Test ◽

Exercise Stress Test ◽

Exercise Stress ◽

Cardioverter Defibrillator

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Electromagnetic Interference with Implantable Cardioverter Defibrillators Causing Inadvertent Shock: Case Report and Review of Current Literature

Clinical Medicine Insights Cardiology ◽

10.4137/cmc.s10990 ◽

2014 ◽

Vol 8 ◽

pp. CMC.S10990 ◽

Cited By ~ 7

Author(s):

Muhammad Akhtar ◽

Tariq Bhat ◽

Mohmad Tantray ◽

Chris Lafferty ◽

Saiful Faisal ◽

...

Keyword(s):

Case Report ◽

Implantable Cardioverter Defibrillator ◽

Current Literature ◽

Electromagnetic Interference ◽

Interesting Case ◽

Implantable Cardioverter Defibrillators ◽

Normal Functioning ◽

Cardioverter Defibrillator ◽

Number Of Patients ◽

Cardioverter Defibrillators

As the number of patients having implantable cardioverter defibrillator (ICD) devices is increasing, it is important for the physicians and patients to be aware of situations and conditions that can result in interference with normal functioning of these devices. There are multiple cases of malfunction of ICDs reported in literature and it may be of great significance to have an overview of these incidents for appropriate recognition and future prevention. Here we are reviewing the available literature as well as reporting an interesting case of electromagnetic interference (EMI) resulting from leak of current in pool water causing firing of ICD.

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Time-to-first appropriate shock in patients implanted prophylactically with an implantable cardioverter-defibrillator: data from the Survey on Arrhythmic Events in BRUgada Syndrome (SABRUS)

EP Europace ◽

10.1093/europace/euy301 ◽

2018 ◽

Vol 21 (5) ◽

pp. 796-802 ◽

Cited By ~ 2

Author(s):

Anat Milman ◽

Aviram Hochstadt ◽

Antoine Andorin ◽

Jean-Baptiste Gourraud ◽

Frederic Sacher ◽

...

Keyword(s):

Implantable Cardioverter Defibrillator ◽

Brugada Syndrome ◽

Cardioverter Defibrillator

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Anesthetic management in a patient with arrhythmogenic right ventricular cardiomyopathy and an implantable cardioverter defibrillator: a case report

Brazilian Journal of Anesthesiology (English Edition) ◽

10.1016/j.bjane.2020.04.012 ◽

2020 ◽

Vol 70 (3) ◽

pp. 302-305

Author(s):

Yoko Ohyama ◽

Hiroshi Hoshijima ◽

Hiroshi Nagasaka ◽

Jun Shimada

Keyword(s):

Case Report ◽

Right Ventricular ◽

Implantable Cardioverter Defibrillator ◽

Arrhythmogenic Right Ventricular Cardiomyopathy ◽

Anesthetic Management ◽

Ventricular Cardiomyopathy ◽

Cardioverter Defibrillator

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Chronic thromboembolic pulmonary hypertension secondary to implantable cardioverter defibrillator lead thrombus in a patient with Brugada syndrome: a rare complication requiring a multidisciplinary approach

BMJ Case Reports ◽

10.1136/bcr-2020-234549 ◽

2020 ◽

Vol 13 (5) ◽

pp. e234549

Author(s):

Sofia Alegria ◽

Filipa Ferreira ◽

Débora Repolho ◽

Maria José Loureiro

Keyword(s):

Pulmonary Hypertension ◽

Implantable Cardioverter Defibrillator ◽

Brugada Syndrome ◽

Rare Complication ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Functional Class ◽

Heart Team ◽

Cardioverter Defibrillator ◽

Thromboembolic Pulmonary Hypertension ◽

Appropriate Shocks

We report the case of a 57-year-old male patient with prior syncope associated with sustained ventricular tachycardia in the setting of Brugada syndrome, who was submitted to implantation of a cardioverter defibrillator for secondary prevention. During follow-up, he presented a significant increase in lead impedance, and a transthoracic echocardiogram showed a mass attached to the lead. He was started on oral anticoagulation after infective endocarditis was excluded but nevertheless suffered repeated episodes of pulmonary embolism that led to severe chronic thromboembolic pulmonary hypertension. After heart team discussion, he was referred to pulmonary endarterectomy and replacement of the implantable cardioverter defibrillator with a subcutaneous device. This led to significant improvement of functional class and normalisation of pulmonary haemodynamics. More recently, he suffered syncope in the setting of ventricular fibrillation with appropriate shocks and was started on quinidine without further recurrence of arrhythmic episodes.

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