PYREXIA-INDUCED BRUGADA PHENOCOPY
AbstractBrugada syndrome (BS) is characterized by a typical electrocardiographic (ECG) pattern in the right precordial leads and a predisposition to develop ventricular arrhythmias. Mutations in α-subunit of cardiac sodium channel (SCN5A) have been linked to BS. Experimental studies in the literature suggest that this dysfunction of the mutated channel can be temperature sensitive. Several antiarrhythmics have been used in the management of BS but Implantable Cardioverter Defibrillators (ICD) remains the only effective treatment. We herewith present the case report of a 62-year-old man who developed a type-2 Brugada ECG phenotype in a febrile state with complete resolution once the fever subsided.Keywords: Brugada syndrome; Electrocardiography; Brugada pattern
Brugada P, Brugada J. Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report. J Am Coll Cardiol 1992;20(6):1391–6.
Brugada R, Brugada J, Antzelevitch C, Kirsch GE, Potenza D, Towbin JA, et al. Sodium channel blockers identify risk for sudden death in patients with ST-segment elevation and right bundle branch block but structurally normal hearts. Circulation 2000;101(5):510–5.
Bayes de Luna A, Brugada J, Baranchuk A, Borggrefe M, Breithardt G, Goldwasser D, et al. Current electrocardiographic criteria for diagnosis of Brugada pattern: a consensus report. J Electrocardiol 2012;45(5):433–42.
Chen Q, Kirsch GE, Zhang D, Brugada R, Brugada J, Brugada P, et al. Genetic basis and molecular mechanism for idiopathic ventricular fibrillation. Nature 1998;392(6673):293–6.
Hedley PL, Jorgensen P, Schlamowitz S, Moolman-Smook J, Kanters JK, Corfield VA, et al. The genetic basis of Brugada syndrome: a mutation update. Hum Mutat 2009;30(9):1256–66.
Antzelevitch C. Genetic basis of Brugada syndrome. Heart Rhythm 2007;4(6):756–7.
Chhabra L, Spodick DH. Brugada pattern masquerading as ST-segment elevation myocardial infarction in flecainide toxicity. Indian Heart J 2012;64(4):404–7.
Adler A, Topaz G, Heller K, Zeltser D, Ohayon T, Rozovski U, et al. Fever-induced Brugada pattern: how common is it and what does it mean? Heart Rhythm 2013;10(9):1375–82.
Amin AS, Meregalli PG, Bardai A, Wilde AA, Tan HL. Fever increases the risk for cardiac arrest in the Brugada syndrome. Ann Intern Med 2008;149(3):216–8.
Dumaine R, Towbin JA, Brugada P, Vatta M, Nesterenko DV, Nesterenko VV, et al. Ionic mechanisms responsible for the electrocardiographic phenotype of the Brugada syndrome are temperature dependent. Circ Res 1999;85(9):803–9.
Junttila MJ, Gonzalez M, Lizotte E, Benito B, Vernooy K, Sarkozy A, et al. Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. Circulation 2008;117(14):1890–3.
Keller DI, Rougier JS, Kucera JP, Benammar N, Fressart V, Guicheney P, et al. Brugada syndrome and fever: genetic and molecular characterization of patients carrying SCN5A mutations. Cardiovasc Res 2005;67(3):510–9.
Delise P, Allocca G, Sitta N, Distefano P. Event rates and risk factors in patients with Brugada syndrome and no prior cardiac arrest: a cumulative analysis of the largest available studies distinguishing ICD-recorded fast ventricular arrhythmias and sudden death. Heart Rhythm 2014;11(2):252–8.
Brugada J, Brugada R, Brugada P. Pharmacological and device approach to therapy of inherited cardiac diseases associated with cardiac arrhythmias and sudden death. J Electrocardiol 2000;33 Suppl:41–7.
Alings M, Dekker L, Sadee A, Wilde A. Quinidine induced electrocardiographic normalization in two patients with Brugada syndrome. Pacing Clin Electrophysiol 2001;24(9 Pt 1):1420–2.
Tsuchiya T, Ashikaga K, Honda T, Arita M. Prevention of ventricular fibrillation by cilostazol, an oral phosphodiesterase inhibitor, in a patient with Brugada syndrome. J Cardiovasc Electrophysiol 2002;13(7):698–701.
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