Sustained Monomorphic Ventricular Tachycardia in a Patient With Brugada Syndrome

概要

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We report a patient with Brugada syndrome who developed sustained monomorphic ventricul vs 470±30 nmol/g protein, p<0.05 at t-BHP 2.0 mmol/L), without evidence of lipid peroxidation or myocardial dysfunction. Pulmonary vascular resistance after CPB was dramatiundle branch block and ST-segment elevation in precorcial 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 dinduced 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 mechanism 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.
社団法人日本循環器学会の論文
1996-05-20