Dorticós BF, Dorantes SM, Arbaiza SJL, Castro HJ, Zayas MR, Quiñones PMA, Fayad RY

Language: Spanish
References: 17
Page: 203-208
PDF size: 186.01 Kb.

ABSTRACT

The Brugada syndrome is the most frequent electrical cause of sudden death in patients with structurally normal heart. It is characterized by ST segment elevation in V1-V3 leads, pseudo right bundle branch block and proneness for episodes of life-threatening ventricular cardiac arrhythmias. The aim of this study was to characterize patients with Brugada syndrome identified in Cuba between 1995 and 2001. Fourteen patients with these electrical signs (13 male and 1 female, mean age 42.8) were studied. Seven of them were symptomatic and seven were not. The pharmacological test with sodium channel blockers was very useful (it was positive for all the patients). HV interval was normal. Programmed ventricular stimulation was performed. Ventricular arrhythmia was inducible in 3 symptomatic patients and 2 asymptomatic. All the symptomatic patients and those asymptomatic in whom ventricular arrhythmia was inducible received automatic defibrillators. One clinical recurrence of ventricular arrhythmias was observed. Antiarrhythmic drugs were only used rarely. Clinical history and electrocardiographic tracings were very important to diagnose this syndrome. There were light, transient or masked electrical signs. The treatment of choice is the implantable cardioverter-defibrillator.

REFERENCES

1. Antzelevitch C, Brugada P, Brugada J, Brugada R, Nademanee K, Towbin J: The Brugada syndrome. En: Camm AJ ed. Clinical approaches to tachyarrhythmias. New York: Future Publishing Company Inc, 1999: vol. 10.

2. Brugada P, Brugada J: Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. J Am Coll Cardiol 1992; 20: 1391-6.

3. Brugada J, Brugada R, Brugada P: Right bundle branch block and ST segment elevation in leads V1 through V3: a marker for sudden death in patients without demonstrable structural heart disease. Circulation 1998; 97: 457-60.

4. Brugada J, Brugada P, Brugada R: Clinical and electrocardiographic patterns in patients with idiopathic ventricular fibrillation. En: Farré J, Moro C, eds. Ten years of radiofrequency catheter ablation. Armonk, NY: Futura Publishing Co, 1998: 219-30.

5. Marcus FI: Idiopathic ventricular fibrillation. J Cardiovasc Electrophysiol 1997; 8: 1075-83.

6. Consensus statement of the joint steering committees of the unexplained cardiac arrest registry of Europe and of the idiopathic ventricular fibrillation registry of the United States: Survivors of out-of-hospital cardiac arrest with apparently normal heart. Need for definition and standardized clinical evaluation. Circulation 1997; 95: 265-72.

7. Brugada J, Brugada R, Brugada P: Fibrilación ventricular idiopática. En: Alzueta J, Fernández LI eds. El desfibrilador implantable. Manual para el cardiólogo clínico. 2da ed. Madrid: ED Alsur 1999: 73-8.

8. García Civera R, Ruiz GR, Morell CS, Sanjuán MR, Martínez LJ, Botella SS, López MV: Electrofisiología cardíaca clínica y ablación. Madrid. McGraw-Hill Interamericana, 1999: 365-74.

9. Frank R, Tonet J, Himbert C, Hidden-Lucet F, Fontaine G: Muerte súbita, epidemiología, prevención primaria y secundaria. En: Valero EM ed. Tratamiento eléctrico de las arritmias. Marcapasos y cardiodesfibriladores. Buenos Aires, Ed. Tiempo, 2000: 171-8.

10. Antzelevitch C: The Brugada syndrome. J Cardiovasc Electrophysiol 1998; 9: 513-6.

11. Antzelevitch C, Yan GX, Shimizu W, Burashnikov A: Electrical heterogeneity, the ECG, and cardiac arrhythmias. En: Zipes DP, Jalife J, eds. Cardiac electrophysiology: from cell to bedside. 3ra ed. Philadelphia: WB Saunders, 1998: 26-1, 26-34.

12. Gussak I, Antzelevitch C, Bjerregaard P, Towbin JA, Chaitman BR: The Brugada syndrome: clinical, electrophysiologic and genetic aspects. J Am Coll Cardiol 1999; 33: 5-15.

13. Alings M, Wilde A: “Brugada” syndrome. Clinical data and suggested pathophysiological mechanism. Circulation 1999; 99: 666-73.

14. Castro J, Dorticós F, Dorantes M, Zayas R, Quiñones MA, Padrón G: Síndrome de Brugada. A propósito de cinco casos. Reblampa 2001; 14: 49-55.

15. Yan GX, Antzelevitch C: Cellular basis of the electrocardiographic J wave. Circulation 1996; 93: 372-9.

16. Brugada R, Brugada J, Antzelevitch C, Kirsch GE, Potenza D, Towbin J et al: Sodium channel blockers identify risk for sudden death in patients with ST- segment elevation and right bundle branch block but structurally normal heart. Circulation 2000; 101: 510-8.

17. Moro C, González RJM, Madrid AH: Resultados clínicos de la eficacia del desfibrilador en la prevención de la muerte súbita y la supervivencia total. Estudios multicéntricos. En: Valero EM, ed. Tratamiento eléctrico de las arritmias. Marcapasos y cardiodesfibriladores. Buenos Aires, Tiempo, 2000: 275-287.