Persistent ST Segment Elevation in Right Precordial ECG Leads and Sudden Death Caused by Ventricular Fibrillation in a Patient Without Structural Heart Disease. (Brugada's Syndrome)

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Abstract

We describe the first patient with the Brugada's syndrome reported in Argentina. A 56 year-old man, without previous history of cardiovascular disease experienced several episodes of presyncope and was assisted in an emergency room, where he collapsed as a result of ventricular fibrillation. The arrhythmia was reverted by a 360-Joule electrical shock. No evidence of structural heart disease was found. The ECGat rest showed a ST segment elevation in leads V1, V2 andV3. This abnormality was attenuated by isoproterenol and magnified by ajmaline. Atrial pacing caused a clear-cut St-T alternation in right precordial ECG leads. Ventricular fibrillation was induced by programmed ventricular pacing and the patient was subsequently treated with an implantable automatic cardioverter-defibrillator. No electrical therapy was delivered by the device during a nine-month follow-up.