Sustained monomorphic ventricular tachycardia in a patient with Brugada syndrome

Megumi Shimada, Toshihisa Miyazaki, Shunichiro Miyoshi, Kyoko Soejima, Shingo Hori, Hideo Mitamura, Satoshi Ogawa

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

We report a patient with Brugada syndrome who developed sustained monomorphic ventricular tachycardia (SMVT). The patient was a 29-year-old man who experienced recurrent episodes of palpitation and syncope after drinking alcohol. Electrocardiogram showed right bundle branch block and ST-segment elevation in precordial leads V(1-3) without Q-Tc prolongation. Organic heart disease and coronary artery disease were excluded by noninvasive and invasive tests. Ventricular fibrillation was induced by the application of a single extrastimulus to the right ventricular outflow tract. During isoproterenol infusion. SMVT of left bundle branch block morphology (240/min) was induced by the application of a single extrastimulus to the right ventricular apex. SMVT also developed spontaneously. Pace mapping disclosed that SMVT originated at the free wall of the right ventricular outflow tract. Head-up tilt test and an alcohol provocation test both induced similar SMVT that was associated with hypotension and near syncope. SMVT was not terminated by intravenous administration of lidocaine, procainamide or adenosine triphosphate (10 mg), but was terminated by propranolol. Thus, a beta- adrenoceptor-mediated mechanisms appears to play an important role in SMVT in this patient. The site of origin of SMVT might be closely related to the lesion that causes ST-segment elevation.

Original languageEnglish
Pages (from-to)364-370
Number of pages7
JournalJAPANESE CIRCULATION JOURNAL
Volume60
Issue number6
DOIs
Publication statusPublished - 1996 Jun 1

Keywords

  • Beta- adrenoceptor stimulation
  • Brugada syndrome
  • Sustained monomorphic ventricular tachycardia

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Sustained monomorphic ventricular tachycardia in a patient with Brugada syndrome'. Together they form a unique fingerprint.

  • Cite this

    Shimada, M., Miyazaki, T., Miyoshi, S., Soejima, K., Hori, S., Mitamura, H., & Ogawa, S. (1996). Sustained monomorphic ventricular tachycardia in a patient with Brugada syndrome. JAPANESE CIRCULATION JOURNAL, 60(6), 364-370. https://doi.org/10.1253/jcj.60.364