Two cases of sudden cardiac death syndrome associated with right bundle branch block and ST segment elevation.
10.4070/kcj.2000.30.5.611
- Author:
Sang Sun PARK
;
Gi Byoung NAM
;
Kee Joon CHOI
;
Jae Kwan SONG
;
Jae Joong KIM
;
Seung Jung PARK
;
Jong Hoon PARK
;
You Ho KIM
- Publication Type:Case Report
- MeSH:
3-Iodobenzylguanidine;
Administration, Intravenous;
Arrhythmias, Cardiac;
Bundle-Branch Block*;
Coronary Angiography;
Coronary Vessels;
Death, Sudden;
Death, Sudden, Cardiac*;
Echocardiography;
Electrocardiography;
Electrolytes;
Exercise Test;
Flecainide;
Heart Diseases;
Humans;
Isoproterenol;
Magnetic Resonance Imaging;
Physical Examination;
Procainamide;
Tachycardia, Ventricular;
Thallium;
Tomography, Emission-Computed, Single-Photon;
Ventricular Fibrillation
- From:Korean Circulation Journal
2000;30(5):611-616
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
In 1992, Brugada described clinical features of patients with aborted sudden cardiac death who showed no demonstrable heart disease and a peculiar ECG pattern consisting of right bundle branch block and ST-segment elevation in right precordial leads. Recently, We experienced two cases with aborted sudden cardiac death and similar ECG pattern. Physical examination, routine laboratory tests including serum electrolytes, echocardiography, myocardial thallium SPECT, MRI and MIBG scans were within normal limit. Arrhythmias were not induced in treadmill exercise test, and signal averaged ECGs revealed positive late potentials. Coronary angiography showed normal coronary artery with no evidence of induced vasospasm. Polymorphic ventricular tachycardia and ventricular fibrillation were induced by ventricular stimulation. Intravenous administration of flecainide, procainamide augmented ST segment elevation in one patient, and isoproterenol reduced ST segment elevation in the other patient. For prevention of sudden death, ICDs were implanted in the two patients. Ventricular fibrillations occurred in one patient 12 and 13 months after the implantation and were successfully terminated by ICD.
