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Titolo:
Syncope in pharmacologically unmasked Brugada syndrome: indication for an implantable defibrillator or an unresolved dilemma?
Autore:
Samniah, N; Iskos, D; Sakaguchi, S; Lurie, KG; Benditt, DG;
Indirizzi:
Univ Minnesota, Sch Med, Cardiac Arrhythmia Ctr, Minneapolis, MN 55455 USAUniv Minnesota Minneapolis MN USA 55455 ia Ctr, Minneapolis, MN 55455 USA
Titolo Testata:
EUROPACE
fascicolo: 2, volume: 3, anno: 2001,
pagine: 159 - 163
SICI:
1099-5129(200104)3:2<159:SIPUBS>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
ST-SEGMENT ELEVATION; BUNDLE-BRANCH BLOCK; IDIOPATHIC VENTRICULAR-FIBRILLATION; SUDDEN CARDIAC DEATH;
Keywords:
vasovagal syncope; Brugada syndrome; head-up tilt table testing;
Tipo documento:
Editorial Material
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
13
Recensione:
Indirizzi per estratti:
Indirizzo: Benditt, DG Univ Minnesota, Sch Med, Cardiac Arrhythmia Ctr, 420 Delaware St SE,MMC 508, Minneapolis, MN 55455 USA Univ Minnesota 420 Delaware St SE,MMC 508 Minneapolis MN USA 55455
Citazione:
N. Samniah et al., "Syncope in pharmacologically unmasked Brugada syndrome: indication for an implantable defibrillator or an unresolved dilemma?", EUROPACE, 3(2), 2001, pp. 159-163

Abstract

A 30-year-old Caucasian male was referred for evaluation of a 2-year history of recurrent post-exertion lightheadedness and near syncopal spells in the setting of a family history of unexplained sudden cardiac death. Cardiacevaluation demonstrated normal heart structure, but the 12-lead surface ECG was suggestive of but not diagnostic of Brugada syndrome. An exercise stress test reproduced the patient's usual symptoms during the recovery period, and was consistent with a typical vasovagal faint. The same symptoms wereobserved during a head-up tilt table test. However, given the family history and EGG, pharmacological testing with procainamide, isoprenaline and metoprolol, as well as programmed ventricular stimulation, were undertaken. Pharmacological provocation further supported a diagnosis of Brugada syndrome, whereas programmed ventricular stimulation was considered non-diagnostic regarding ventricular tachyarrhythmia susceptibility. Consequently, despiteECG and pharmacological findings suggestive of Brugada syndrome, there appeared to be sufficient evidence to believe that this patient's symptoms were the result of neurally mediated syncope and not due to ventricular tachyarrhythmias. The patient was treated with midodrine, and has remained symptom-free for 16 months. Thus, given the frequency with which vasovagal syncope occurs in young patients, its occurrence is not unexpected in individualswith concomitant diagnoses such as Brugada syndrome. In as much as currentrecommendations favour implantable defibrillators in symptomatic Brugada syndrome, the identification of other causes of syncope in such patients poses an uncomfortable, and currently unsettled dilemma. (Europace 2001; 3: 159-163) (C) 2001 The European Society of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/04/20 alle ore 08:22:40