Key result
In a patient without structural heart disease, J wave and ST segment elevation in the inferior leads were augmented by pilsicainide, and ventricular fibrillation was electrically induced.
Case Report (n=1)
No
J wave and ST segment elevation in the inferior leads, augmented by sodium channel blockers, may represent a latent type of variant Brugada syndrome in patients with inducible ventricular fibrillation.
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May indicate latent variant Brugada syndrome; leaves open whether sodium channel blocker testing identifies high-risk patients.
In a patient referred for the evaluation of non-sustained monomorphic ventricular tachycardia on Holter recordings, ventricular fibrillation was electrically induced during electrophysiologic study. Despite the absence of structural heart diseases, his ECG revealed J wave and ST segment elevation in the inferior leads, which showed circadian variation and were augmented by the sodium channel blocker, pilsicainide. This case might lead us to notice a new concept, a 'latent' type of variant Brugada syndrome, and these ECG findings and changes might serve as its diagnostic sign.
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Sahara et al. (2002) conducted a case report in Variant Brugada syndrome (n=1). Pilsicainide was evaluated on ECG changes and induction of ventricular fibrillation. In a patient without structural heart disease, J wave and ST segment elevation in the inferior leads were augmented by pilsicainide, and ventricular fibrillation was electrically induced.
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