Key result
Percutaneous epicardial catheter ablation significantly reduced ST segment amplitude and, combined with quinidine, prevented further ICD shocks over an 8-year follow-up in a patient with Brugada syndrome.
Why the study?
Brugada syndrome causes sudden death due to ventricular fibrillation, and treatment options have traditionally been limited to medications and implantable cardioverter-defibrillators.
Case Report (n=1)
No
Epicardial catheter ablation can be an effective treatment option for patients with Brugada syndrome experiencing recurrent ventricular fibrillation and ICD shocks.
May support epicardial ablation plus quinidine in refractory Brugada; leaves open confirmation in controlled trials.
Brugada症候群は，心室細動による突然死をおこす症候群であり治療には，薬物と植込み型除細動器の2つの選択肢しかなかった。症例は30歳男性，特記すべき既往歴なく祖父（父方）37歳，父27歳で突然死の家族歴あり。就寝中に痙攣して意識戻らず救急要請。救急隊接触時は心室細動であり，当院到着までに除細動の使用を要した。当院到着後は自然に洞調律となり，第3病日に意識が戻り抜管となった。蘇生時の心電図波形からBrugada症候群と診断され，第6病日に植込み型除細動器の植込みとなった。退院後，植込み型除細動器の作動を10回認め，心外膜アプローチアブレーションの選択となった。 当院にて初めてBrugada症候群に対して心外膜アプローチアブレーションを施行し，良好な結果が得られたため報告する。
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Ogawa et al. (2020) conducted a case report in Brugada Syndrome (n=1). Percutaneous epicardial catheter ablation was evaluated on Prevention of ICD shocks and reduction of ST segment amplitude. Percutaneous epicardial catheter ablation significantly reduced ST segment amplitude and, combined with quinidine, prevented further ICD shocks over an 8-year follow-up in a patient with Brugada syndrome.
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