[SCD-FORUM] 72S RE: Brugada pattern post-PAF reversion. Dr. Rondon

[SCD Symposium]

Dr. Silvano Diangelo
Argentina

Dear Dr.
I dare to express an opinion about this case, because I have had 6  
cases of young boys with Brugada pattern, 1 triggered by exercise, 2  
triggered by drugs, and 3 with spontaneous expression, who were  
studied with SA-ECG, with presence of late potentials and  
echocardiographic evaluation with maintained LV function. I think the  
EPS is very important to be accurate about malignant arrhythmia  
induction, even when there are cases in which it is not possible to  
induce sustained VT.

I think that a patient with stratification of:

Brugada pattern in any of its manifestations
With SA-ECG with evidence of late potentials
Evidence in EPS of sustained malignant arrhythmia induction.

Should go to protection with ICD, even when I am well aware that it  
is not easy to implant a system in asymptomatic patients; but the  
idea is to protect them from SCD events, which could be the only and  
last arrhythmic manifestation in this patient.

Dr Mauricio Rondón
Caracas - Venezuela

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee

>
> I would like to ask Dr. Andres Perez Riera about a 35-year-old,  
> male patient, with no structural heart disease or family history of  
> SCD, baseline ECG with incomplete right bundle branch block with  
> superior axis, who presents for the first time with Paroxysmal  
> Atrial Fibrillation, which after being reverted with oral  
> propafenone 600 mg (UD), induces ECG with Brugada pattern.
> What is the prognosis? Therapeutics?
> Does he need an additional screening (genetic, EPS)?
> Is he really a Brugada patient or is this just the effect of the  
> drug, producing Brugada-like pattern?
>
> Thank you very much.
>
> Kind regards,
> Dr. Silvano Diangelo
> Argentina
>
>

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