A comprehensive multimodal diagnostic approach in a 51-year-old man with a fever-induced type-1 Brugada ECG pattern revealed an underlying biventricular structural scar cardiomyopathy.
Case Report (n=1)
This case demonstrates that the presence of overt myocardial scar and biventricular arrhythmogenic substrate in a patient with a Brugada ECG pattern should prompt consideration of an alternative structural cardiomyopathy diagnosis.
ABSTRACT Although Brugada syndrome has traditionally been considered a primary electrical disease, accumulating evidence supports the presence of subtle structural abnormalities, particularly involving the right ventricular outflow tract. Nevertheless, the identification of overt myocardial scar and biventricular arrhythmogenic substrate should prompt consideration of an alternative diagnosis. We report the case of a 51‐year‐old man presenting with syncope during a febrile illness and a transient spontaneous type‐1 Brugada ECG pattern. Initial evaluation was unremarkable. However, Holter monitoring revealed multifocal ventricular ectopy, including non‐sustained ventricular tachycardia (NSVT) with both left and right bundle branch block morphologies, suggesting biventricular origin. Cardiac magnetic resonance showed a non‐ischemic subepicardial scar, and electroanatomical mapping identified additional right ventricular abnormalities. Programmed stimulation induced sustained ventricular arrhythmias. These findings supported the presence of an underlying biventricular structural scar cardiomyopathy presenting with a fever‐induced type‐1 Brugada ECG pattern. The patient underwent transvenous ICD implantation. This case highlights the importance of a comprehensive multimodal diagnostic approach.
Scarà et al. (Tue,) conducted a case report in Brugada syndrome / Biventricular structural scar cardiomyopathy (n=1). Multimodal diagnostic approach was evaluated on Diagnosis of underlying biventricular structural scar cardiomyopathy. A comprehensive multimodal diagnostic approach in a 51-year-old man with a fever-induced type-1 Brugada ECG pattern revealed an underlying biventricular structural scar cardiomyopathy.