Megumi Nakamura

Successful prevention of recurrent ventricular fibrillation by intravenous isoproterenol in a patient with Brugada syndrome.

TANAKA, H., et al.: Successful Prevention of Recurrent Ventricular Fibrillation by Intravenous Isoproterenol in a Patient with Brugada Syndrome. Intravenous administration of isoproterenol restored the ST‐segment configuration to nearly normal in the right precordial leads and completely prevented spontaneous VF attacks in a patient with Brugada syndrome. The formation of a Brugada‐type ECG has been attributed to the transmural dispersion of repolarization of the right ventricular epicardium and related to modulation of the autonomic nervous system. Our case may provide clues to the pathophysiological mechanism of this syndrome.

Incessant ventricular fibrillation attacks in a patient with Brugada syndrome

A 42-year-old man was hospitalized for investigation of repeated episodes of ventricular fibrillation (Vf). Electrocardiogram (ECG) showed typical features of Brugada syndrome. Echocardiography, coronary angiography and endomyocardial biopsy specimen were normal. 123I-MIBG scintigraphy showed homogeneous reduction of uptake. The patient demonstrated 17 episodes of Vf in 1 day, but these were terminated by direct cardioversion. Spectral analysis of heart rate variability demonstrated increased sympathetic activity followed by Vf attacks.