RESUMO
BACKGROUND: Brugada syndrome (BrS) includes a group of patients with a typical pattern of ST segment elevation in right precordial leads who are at risk for sudden cardiac death. The electrocardiogram pattern may be intermittent and unmasked by sodium channel blockers. The main objective of this study is to describe a serie of consecutive patients in whom oral administration of flecainide was used to unmask BrS type I electrocardiographic pattern. METHODS: We prospectively studied 14 symptomatic (palpitations/syncope) patients referred to our laboratory presenting a suggestive but not diagnostic Brugada ECG or family history of sudden death. Single oral dose of flecainide 400 mg was administered. Resting 12-lead ECG with upper and standard right precordial leads were performed after flecainide administration at 15, 30, 60 and 90 min and hourly until ECG became normal. RESULTS: Median age was 37.5 years (range = 22-50). None of them had structural heart disease. In 7 patients (50%) the typical coved-type ECG pattern of BrS was unmasked. PR interval, QRS duration and QTc median difference after-before test was 20 msec (min-max = -17-+57), 21 ms (min-max = 0 to +59) and 20 ms (min-max = -11-+77), respectively. There were no episodes of AV block, atrial or ventricular tachyarrhythmia. CONCLUSIONS: In our experience we found that oral administration of flecainide in a single dose of 400 mg is useful to unmask type 1 Brugada electrocardiographic pattern.
Assuntos
Síndrome de Brugada/diagnóstico , Eletrocardiografia , Flecainida , Bloqueadores dos Canais de Sódio , Administração Oral , Adulto , Síndrome de Brugada/fisiopatologia , Feminino , Flecainida/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Bloqueadores dos Canais de Sódio/administração & dosagemRESUMO
Implanted cardiodefibrillators devices are being used with increasing frequency to provide primary and secondary prevention of arrhythmic sudden death. Between March 2003 through Febraury 2005, 99 consecutive patients were included in a study to test the defibrillation threshold at the time of an implantable cardiofibrillator insertion. The systematic measurement of defribillation threshold during the insertions of an implanted defibrillator, still is a necessary resource in order to identify patients in whom the margins of standard security could not guarantee a successful defibrillation. The possibility to identify elevated defibrillation threshold testing is very important to be determined at the time of indications for the insertion of an implanted cardiodefibrillator. These consideations are discussed in the article
Assuntos
Adolescente , Adulto , Masculino , Humanos , Feminino , Cardioversão Elétrica , Desfibriladores ImplantáveisRESUMO
Implanted cardiodefibrillators devices are being used with increasing frequency to provide primary and secondary prevention of arrhythmic sudden death. Between March 2003 through Febraury 2005, 99 consecutive patients were included in a study to test the defibrillation threshold at the time of an implantable cardiofibrillator insertion. The systematic measurement of defribillation threshold during the insertions of an implanted defibrillator, still is a necessary resource in order to identify patients in whom the margins of standard security could not guarantee a successful defibrillation. The possibility to identify elevated defibrillation threshold testing is very important to be determined at the time of indications for the insertion of an implanted cardiodefibrillator. These consideations are discussed in the article
Assuntos
Adolescente , Adulto , Masculino , Humanos , Feminino , Desfibriladores Implantáveis , Cardioversão ElétricaRESUMO
Syncope is a symptom characterized by transient and autolimited loss of consciousness, generally accompanied by the inhability to stand upright and maintain postural tone, spontaneous recovery and without sequelae. It is produced by a sudden cerebral global and transient hypoperfussion. After assessment of the symptoms and its possible mechanism, it is mandatory to determine if it is an essential syncope or otherwise another entity resembling a syncope, in order to discard it rapidly....Other details are commented in the article
Assuntos
Humanos , Masculino , Adulto , Algoritmos , Síncope/diagnóstico , EletrofisiologiaRESUMO
Syncope is a symptom characterized by transient and autolimited loss of consciousness, generally accompanied by the inhability to stand upright and maintain postural tone, spontaneous recovery and without sequelae. It is produced by a sudden cerebral global and transient hypoperfussion. After assessment of the symptoms and its possible mechanism, it is mandatory to determine if it is an essential syncope or otherwise another entity resembling a syncope, in order to discard it rapidly....Other details are commented in the article