Key result
Brugada syndrome was diagnosed in a 49-year-old woman who developed ventricular fibrillation and abnormal ST elevation during paced rhythm 10 months after DDD pacemaker implantation.
Case Report (n=1)
Brugada syndrome can manifest and be observed during pacing therapy even if classic ECG findings are initially absent, highlighting the need for vigilance in patients with pacemakers.
Pacing may unmask Brugada syndrome without prior ECG changes; single case leaves open need for routine paced-rhythm scrutiny.
A 49-year-old woman experienced syncope 10 months after DDD pacemaker implantation for sick sinus syndrome. ECG revealed abnormal ST elevation in leads V1 to V3 during a paced rhythm. Multifocal premature ventricular contractions followed by ventricular fibrillation were documented. Saddleback-type ST elevation was confirmed after a mode change to AAI. The diagnosis of Brugada syndrome was made, and the DDD pacemaker was upgraded to an implantable cardioverter defibrillator. Brugada syndrome can be easily overlooked if the classic ECG findings are not initially noted but may be observed even during pacing therapy.
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Nakazato et al. (2004) conducted a case report in Sick sinus syndrome, Brugada syndrome (n=1). DDD pacemaker implantation was evaluated. Brugada syndrome was diagnosed in a 49-year-old woman who developed ventricular fibrillation and abnormal ST elevation during paced rhythm 10 months after DDD pacemaker implantation.
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