Document Detail


Sustained monomorphic ventricular tachycardia in a patient with Brugada syndrome.
MedLine Citation:
PMID:  8844303     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report a patient with Brugada syndrome who developed sustained monomorphic ventricular tachycardia (SMVT). The patient was a 29-year-old man who experienced recurrent episodes of palpitation and syncope after drinking alcohol. Electrocardiogram showed right bundle branch block and ST-segment elevation in precordial leads V1-3 without Q-Tc prolongation. Organic heart disease and coronary artery disease were excluded by noninvasive and invasive tests. Ventricular fibrillation was induced by the application of a single extra-stimulus to the right ventricular outflow tract. During isoproterenol infusion, SMVT of left bundle branch block morphology (240/min) was induced by the application of a single extrastimulus to the right ventricular apex. SMVT also developed spontaneously. Pace mapping disclosed that SMVT originated at the free wall of the right ventricular outflow tract. Head-up tilt test and an alcohol provocation test both induced similar SMVT that was associated with hypotension and near syncope. SMVT was not terminated by intravenous administration of lidocaine, procainamide or adenosine triphosphate (10 mg), but was terminated by propranolol. Thus, a beta-adrenoceptor-mediated mechanism appears to play an important role in SMVT in this patient. The site of origin of SMVT might be closely related to the lesion that causes ST-segment elevation.
Authors:
M Shimada; T Miyazaki; S Miyoshi; K Soejima; S Hori; H Mitamura; S Ogawa
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Japanese circulation journal     Volume:  60     ISSN:  0047-1828     ISO Abbreviation:  Jpn. Circ. J.     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1996-12-31     Completed Date:  1996-12-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7806868     Medline TA:  Jpn Circ J     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  364-70     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Electrocardiography*
Female
Humans
Male
Syndrome
Tachycardia, Ventricular / physiopathology*

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