Why the study?
Does pharmacological therapy (cilostazol or quinidine) attenuate J-waves and suppress ventricular fibrillation in patients with Brugada syndrome?
Does pharmacological therapy (cilostazol or quinidine) attenuate J-waves and suppress ventricular fibrillation in patients with Brugada syndrome?
J-wave attenuation following administration of cilostazol or quinidine may serve as a marker of drug efficacy for suppressing ventricular fibrillation in Brugada syndrome.
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May suggest quinidine or cilostazol efficacy in Brugada syndrome; hypothesis-generating case report requiring prospective validation.
We herein describe two patients with Brugada syndrome in whom J-waves were successfully modified by drugs. Case 1 was a 54-year-old man who presented with repeated ventricular fibrillations (VF) and J-point elevation in the right precordial and lateral leads. After administration of cilostazol (200 mg/d), J-waves disappeared and coved-type ST-segment elevation changed to a saddleback-type for 25 months. Case 2 was a 31-year-old man who presented with a VF storm and J-point elevation in the lateral leads. After administration of quinidine (300 mg/d), J-waves and coved-type ST-segment elevation disappeared for 20 months. J-wave disappearance and coved-type ST-segment elevation were followed by VF suppression, probably due to transient outward potassium current (Ito) suppression.
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Hasegawa et al. (2014) studied this question.
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