Brugada syndrome and idiopathic left ventricular tachycardia unmasked by exercise and a class Ic drug

J Electrocardiol. 2014 Sep-Oct;47(5):721-4. doi: 10.1016/j.jelectrocard.2014.04.022. Epub 2014 May 4.

Abstract

The patient was a 33-year-old male. Twenty years ago, he underwent radiofrequency catheter ablation for idiopathic sustained monomorphic ventricular tachycardia (VT) with an RBBB and superior axis pattern. The VT was inducible by programmed stimulation and entrained by rapid pacing. At this presentation, he developed palpitation and VT with the same morphology at the peak exercise on a treadmill with appearance of typical ECG pattern for Brugada syndrome (BrS). Pilsicainide induced the typical ECG pattern and premature ventricular beats (PVBs) of the same morphology as VT. The relationship between BrS and VT of left ventricular origin was discussed.

Keywords: Brugada syndrome; Exercise; Pilsicainide; Ventricular tachycardia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Arrhythmia Agents*
  • Brugada Syndrome / diagnosis*
  • Brugada Syndrome / physiopathology
  • Brugada Syndrome / therapy
  • Cardiac Catheterization
  • Defibrillators, Implantable
  • Electrocardiography*
  • Exercise Test*
  • Humans
  • Lidocaine / analogs & derivatives*
  • Male
  • Tachycardia, Ventricular / diagnosis*
  • Tachycardia, Ventricular / physiopathology
  • Tachycardia, Ventricular / therapy

Substances

  • Anti-Arrhythmia Agents
  • Lidocaine
  • pilsicainide