Role of Catheter Ablation for Ventricular Arrhythmias in Brugada Syndrome

Fig. 1. A 12 lead EKG of a BrS patient showing type I Brugada ECG pattern with a signature curved-type ST elevation in V1 and V2 (arrows).

Fig. 2. An example of electroanatomic mapping of VF substrates from a BrS patient who had recurrent VF episodes triggering multiple ICD discharges. The electroanatomical maps display areas of fractionated electrograms during sinus rhythm recorded with a 20-pole Lasso catheter in the RV epicardium. The maps are displayed in the anterior posterior (AP) and the left anterior oblique (LAO). Abnormal fractionated potential over the RVOT, RV body, and RV inferolateral are shown in the first and the third insets organized in the following fashion: The top 4 tracings are L1, AVL, V1, and V2 positioned at the 3rd intercostal space (V1ICS3 and V2 ICS3 respectively) followed with 10 bipolar recordings from the Lasso catheter and the Unipolar recordings from the Lasso poles 1, 3,5,7, 9,11,13, 15, 17, and 19). The first inset is the Lasso catheter recordings from the RV inferior epicardium and exhibits fractionated signals from the bipolar recordings from the Lasso 17–18 and 19–20. The third inset is the lasso catheter recordings from the RVOT epicardium and show abnormal fractionated late electrograms in all bipolar and unipolar recordings. The red dots on the electroanatomical maps represent VF…

Fig. 3. Normalization of Brugada ECG pattern in V1 and V2 after ablation. Both EKGs were taken after ajmaline administration (50 mg)