Dynamic electrocardiographic changes after aborted sudden death in a patient with Brugada syndrome and rate-dependent right bundle branch block

A 37-year-old man with Brugada syndrome and dynamic changes of the ST-segment morphology observed after an episode of aborted sudden death is described. On admission, after 3 syncopal episodes during nighttime, his electrocardiogram showed right bundle branch block (RBBB) with a J-point elevation of...

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Bibliographic Details
Published in:Journal of electrocardiology 2005-07, Vol.38 (3), p.256-259
Main Authors: Márquez, Manlio F., Bisteni, Abdo, Medrano, Gustavo, De Micheli, Alfredo, Guevara, Milton, Iturralde, Pedro, Colín, Luis, G. Hermosillo, Antonio, Cárdenas, Manuel
Format: Article
Language:English
Subjects:
Adult
Arrhythmia, Sinus - etiology
Bradycardia - etiology
Brugada syndrome
Bundle-Branch Block - complications
Bundle-Branch Block - therapy
Defibrillators, Implantable
Electrocardiography - classification
Electrocardiography - methods
Follow-Up Studies
Heart Arrest - therapy
Heart Ventricles - physiopathology
Humans
Implantable defibrillator
Male
Right bundle branch block
Sudden cardiac death
Syncope - etiology
Syndrome
Ventricular fibrillation
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Summary:A 37-year-old man with Brugada syndrome and dynamic changes of the ST-segment morphology observed after an episode of aborted sudden death is described. On admission, after 3 syncopal episodes during nighttime, his electrocardiogram showed right bundle branch block (RBBB) with a J-point elevation of 0.6 mV in lead V 2. Changes observed in the following days included a diminished J-point elevation and intermittent “saddle-back” type of morphology. During a previous 2-year follow-up, intermittent, complete, acceleration-dependent RBBB was documented. Right ventricular intracavitary tracings showed an RS pattern with a broad S wave in the unipolar electrogram; the time of onset of intrinsic deflection in this electrogram was 60 milliseconds. To our knowledge, this is the first report of an intracavitary demonstration of complete RBBB in Brugada syndrome.
ISSN:0022-0736
1532-8430
DOI:10.1016/j.jelectrocard.2005.03.004