Brugada syndrome—Malignant phenotype associated with acute cardiac inflammation? Anthony Li, MBBS, MD, Roderick Tung, MD, FHRS, Kalyanam Shivkumar, MD,

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Presentation transcript:

Brugada syndrome—Malignant phenotype associated with acute cardiac inflammation? Anthony Li, MBBS, MD, Roderick Tung, MD, FHRS, Kalyanam Shivkumar, MD, PhD, FHRS, Jason S. Bradfield, MD, FHRS HeartRhythm Case Reports Volume 3, Issue 8, Pages 384-388 (August 2017) DOI: 10.1016/j.hrcr.2017.04.011 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 Images from case 1. A: A 12-lead electrocardiogram in a standard configuration during procainamide testing showing a type 1 Brugada syndrome pattern in leads V1 and V2. B: Epicardial right ventricular/right ventricular outflow tract (RVOT) voltage map with low-voltage, fractionated electrograms tagged (green and pink dots). Typical electrogram appearances are shown at their locations (white arrows). C: Normal endocardial RVOT voltage. D: Positron emission tomography–computed tomography (PET/CT) showing posterior wall fluorodeoxyglucose uptake (red arrow). E: Epicardial left ventricle map showing area of low voltage (red) corresponding to area of uptake on PET/CT. F: Fluoroscopic anteroposterior view of ablation catheter in the epicardium overlying the RVOT. G: Implantable defibrillator traces showing onset of ventricular fibrillation and termination by a single 36 J shock. HeartRhythm Case Reports 2017 3, 384-388DOI: (10.1016/j.hrcr.2017.04.011) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 Images from case 2. A: A 12-lead electrocardiogram in a standard configuration during procainamide testing showing a type 1 Brugada syndrome pattern in leads V1 and V2. B: Epicardial right ventricular/right ventricular outflow tract (RVOT) voltage map with low-voltage, fractionated electrograms tagged (green dots). Typical electrogram appearances are shown at their locations (white arrows). C: Normal endocardial RVOT voltage. D: Positron emission tomography–computed tomography (PET/CT) showing posterior left ventricle (LV) wall and basal septum uptake (red arrows). E: Epicardial LV map showing area of low voltage (red) corresponding to area of uptake on PET/CT. F: Fluoroscopic anteroposterior view of ablation catheter (Abl) in the epicardium overlying the RVOT. G: Implantable defibrillator traces showing termination of ventricular fibrillation by a single 36 J shock. HeartRhythm Case Reports 2017 3, 384-388DOI: (10.1016/j.hrcr.2017.04.011) Copyright © 2017 Heart Rhythm Society Terms and Conditions