[SCD-FORUM] 75E RE: Brugada's pattern detection in a son of SCD's patient. Dr. Makarov

[SCD Symposium]

I think asymptomathic patient with 1 type of Brugada syndrome need   
in  follow up with ECG control, Holter and information to avoid  
potentially dangerouse drugs and conditions: antyarrhythmic drugs (Na  
blockers),  high temperature, rapid vagus stimulation vagus (diving  
and other). One of our patients with transient 1 type of Brugada  
symptom had synsope only during eating and high temperature.
Leonid Makarov M.D., PhD. Professor of Medicine (Pediatry). Moscow  
Institute pediatry and children surgery. Center for children  
arrhythmia, Dpt diagnostic of arrhythmia.
125412 Moscow, Taldomskaa str. 2 Russsia leo at oss.ru

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee


>
> If type I ecg is present, pharmacologic test is not indicated, the  
> diagnosis
> is made.
>
> Some investigators will go ahead and implant a defibrillator,  
> because of the
> family history
>
> Others will wait until he develops any symptoms
>
> I recommend an EPS to risk stratify. If positive then ICD implant.
>
>
> Ramon Brugada MD FACC
> Associate Professor of Medicine
> Canadian Research Chair Genetics of Arrhythmias
> University of Montreal
> Director Clinical Cardiovascular Genetics Center
> Montreal Heart Institute
> 5000 Rue Belanger
> Montreal, QC H1T 1C8
> Canada
>
> ramon at brugada.org
>
>
>>
>> Dear Sergio,
>> About a case of reanimation of sudden death in a 54-year-old  
>> patient, with no structural heart disease, with all the studies  
>> made: coronary angiography, MNR, Holter, EPS.
>> Everything appears to be normal. Monomorphic arrhythmic storm is  
>> detected at the moment the patient is admitted. The patient is  
>> provided life support and he recovers in 24 hs. ICD implantation  
>> is decided. After three months he displays three shocks by  
>> arrhythmic storm, incessant ventricular tachycardia. Mapping and  
>> focus ablation is decided, in outflow tract with mismatch.
>> To this moment, the patient has not displayed any event. It's been  
>> three months, and in a Holter register in one of his sons, typical  
>> Brugada pattern is observed. The patient is 17 years old,  
>> asymptomatic. I cannot perform pharmacological test. What should I  
>> do next?
>>
>> Dr. Cagnolatti  <drcagnolattia at hotmail.com>
>>
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