Aborted sudden death in a patient with a structurally normal heart: the Brugada syndrome

Byline: D. Scherr (1), G. Brunner (1), P. Kaufmann (1), P. Lercher (1), A. Lueger (1), B. Rotman (1), K. Smolle (1), G. Stark (1), W. Klein (1), G. Krejs (1) Keywords: Ajmaline Arrhythmia Brugada syndrome Ventricular fibrillation ST segment elevation Sudden death Abstract: We report a 37-year-old man with documented aborted sudden death. After resuscitation, the patient showed no structural heart disease but the ECG showed a right bundle-branch block with a descending ST segment elevation in leads V.sub.1 and V.sub.2. After transient normalization of the ECG, the administration of ajmaline led to spontaneous development of the distinct descending ST segment elevation in the right precordial leads and therefore to the diagnosis of Brugada syndrome. The incidence of sudden cardiac death among these patients is high. The only treatment is an implantable cardioverter-defibrillator (ICD). The Brugada syndrome should therefore be borne in mind in the differential diagnosis of sudden death. Author Affiliation: (1) Department of Internal Medicine, Karl-Franzens-University Hospital, Auenbruggerplatz 15, 8036 Graz, Austria Article History: Received Date: 14/08/2001 Accepted Date: 12/03/2002 Article note: Electronic Publication