Why the study?
Does epicardial infundibular substrate ablation alter the electrocardiographic phenotype in a patient with Brugada syndrome?
Does epicardial infundibular substrate ablation alter the electrocardiographic phenotype in a patient with Brugada syndrome?
Epicardial ablation for Brugada syndrome can eliminate the characteristic ECG pattern but may unmask inferior J waves and an early repolarization phenotype, raising questions about long-term arrhythmic risk.
May unmask inferior J waves after Brugada ablation; leaves open arrhythmic risk implications for prospective study.
Patients with Brugada syndrome are at risk of life-threatening ventricular arrhythmias. Epicardial substrate ablation for Brugada syndrome has been described as a means of controlling these arrhythmias and recent reports describe elimination of the Brugada phenotype with ablation. We describe a unique case in which a patient developed inferior J waves with an early repolarization-type electrocardiogram following successful epicardial infundibular substrate ablation (which eliminated the Brugada syndrome electrocardiogram on ajmaline challenge). We discuss the likely underlying pathophysiology responsible for this phenomenon, its relationship to the anatomic obstacles encountered during epicardial ablation, and the implications for long-term arrhythmic risk.
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Lee et al. (2017) studied this question.
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