PYREXIA-INDUCED BRUGADA PHENOCOPY

Authors

  • Nauman Khalid
  • Lovely Chhabra
  • Jeffrey Kluger

Abstract

Brugada 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

References

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.

Downloads

Published

2015-03-01

How to Cite

Khalid, N., Chhabra, L., & Kluger, J. (2015). PYREXIA-INDUCED BRUGADA PHENOCOPY. Journal of Ayub Medical College Abbottabad, 27(1), 228–31. Retrieved from https://jamc.ayubmed.edu.pk/jamc/index.php/jamc/article/view/1148

Issue

Vol. 27 No. 1 (2015): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

CASE REPORT

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.