Type 1 Brugada Pattern Unmasked During the Recovery Period of an Exercise Stress Test

García-Fuertes, Daniel; Fernández, E.; Crespín-Crespín, Manuel; Puchol, Alberto; Pachón, Marta; Arias, Miguel Á.

doi:10.5935/abc.20160071

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…Augmentation of ST-segment elevation during the recovery phase of exercise stress test can unmask type I Brudaga pattern ECGs, likely due to increased parasympathetic activity. 7 In one study of a group of 93 BrS patients, ST-segment augmentation of >0.05 mV during recovery from exercise was seen in 34 (37%) but in none of the 102 healthy controls and its presence was predictive of future cardiac events. 8 In our patient, the type 1 Brugada pattern ECG during recovery from exercise could have been considered both diagnostic for BrS and counted as a risk factor for future events.…”

Section: Discussionmentioning

confidence: 99%

Ventricular fibrillation arrest due to Brugada syndrome in a coronavirus disease 2019 patient with negative procainamide challenge: a case report

Zou

Khanna

Zahid

et al. 2021

European Heart Journal - Case Reports

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Background Pharmacologic challenge test is often used to diagnose Brugada syndrome (BrS) when spontaneous ECGs do not show type I Brugada pattern but reported sensitivity varies. The role of exercise stress test in diagnosing Brugada syndrome is not well-established. Case Summary A patient had a type I Brugada pattern ECG during the recovery phase of exercise stress test but had a negative procainamide challenge test. He had a loop recorder implanted and later survived a ventricular fibrillation (VF) arrest provoked by COVID-19. ECG on arrival showed type 1 Brugada pattern. He was discharged after implantable cardioverter-defibrillator (ICD) implantation. He later underwent genetic testing and was found to be heterozygous for c.844C>G (p.Arg282Gly) mutation in the SCN5A gene. Discussion Type 1 Brugada pattern ECG may be unmasked by ST segment augmentation during recovery from exercise. Exercise stress test may play a role in diagnosis of Brugada syndrome when suspicion for Brugada syndrome remains after a negative procainamide challenge test or if the patient has exercise related symptoms. COVID-19 can unmask BrS and trigger a VF cardiac arrest.

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Section: Discussionmentioning

confidence: 99%

Ventricular fibrillation arrest due to Brugada syndrome in a coronavirus disease 2019 patient with negative procainamide challenge: a case report

Zou

Khanna

Zahid

et al. 2021

European Heart Journal - Case Reports

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“…This disease has a higher incidence in adult males. The symptoms occur mainly during rest or sleep 8 .…”

Section: Discussionmentioning

confidence: 99%

Brugada Pattern Mimicking Myocardial Acute Infarct

Castro

Lima

Vitorino

2020

J Cardiac Arrhtythmias

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Brugada syndrome (BrS) has been described as an arrhythmic disorder characterized by ST elevation with successive negative T wave in the right precordial leads. Patients are at risk for sudden cardiac death (SCD) due to ventricular fibrillation (VF). This specific electrocardiogram (ECG) pattern can sometimes be confused with ST elevation myocardial ischemia. This report shows a patient who presented with chest pain and had an ECG compatible with Brugada. An ischemic workup was performed, and acute coronary syndrome was ruled out. He had a final diagnosis of BrS and was discharged home after the placement of an automatic defibrillator.

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“…Sinus tachycardia during exercise attenuates ST elevation, but vagal activation during the recovery phase augments ST elevation and unmasks type 1 ECG in patients with BrS . Makimoto et al.…”

Section: Discussionmentioning

confidence: 99%

“…Symptoms often arise at rest or during sleep, in a febrile state. Lethal ventricular arrhythmias tend to occur during the recovery phase after exercise, in association with significant augmentation of ST elevation …”

Section: Introductionmentioning

confidence: 99%

“…Lethal ventricular arrhythmias tend to occur during the recovery phase after exercise, in association with significant augmentation of ST elevation. 4 A subcutaneous implantable cardioverter-defibrillator (S-ICD) does not require placement of leads directly into the heart, so use of these devices could avoid the complications related to the use of transvenous ICD leads. Moreover, since the incidence of lead injury increases over time after transvenous ICD implantation, use of S-ICDs is expected to avoid troubles concerning cardiac leads, 5-7 especially in younger patients without organic heart disease, such as patients with BrS, who do not usually need ventricular pacing.…”

Section: Introductionmentioning

confidence: 99%

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Exercise stress test reveals ineligibility for subcutaneous implantable cardioverter defibrillator in patients with Brugada syndrome

Tachibana

Nishii

Morita

et al. 2017

Cardiovasc electrophysiol

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Type 1 Brugada Pattern Unmasked During the Recovery Period of an Exercise Stress Test

Cited by 5 publications

References 10 publications

Ventricular fibrillation arrest due to Brugada syndrome in a coronavirus disease 2019 patient with negative procainamide challenge: a case report

Ventricular fibrillation arrest due to Brugada syndrome in a coronavirus disease 2019 patient with negative procainamide challenge: a case report

Brugada Pattern Mimicking Myocardial Acute Infarct

Exercise stress test reveals ineligibility for subcutaneous implantable cardioverter defibrillator in patients with Brugada syndrome

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