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https://www.readbyqxmd.com/read/29215340/a-report-of-brugada-syndrome-presenting-with-cardiac-arrest-triggered-by-verapamil-intoxication
#1
Kahraman Yakut, İlkay Erdoğan, Birgül Varan, İlyas Atar
BACKGROUND: Brugada syndrome is a disease characterized by a specific electrocardiographic pattern and an increased risk of sudden cardiac death. We present this case with the updated literature to emphasise the need to consider the diagnosis of Brugada syndrome in patients admitted to the emergency ward with sudden cardiac arrest. CASE REPORT: A 16-year-old female patient was admitted to the emergency ward with complaints of weakness and abdominal pain, and she had four cardiac arrests during her evaluation period...
December 1, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/29172153/ajmaline-blocks-ina-and-ikr-without-eliciting-differences-between-brugada-syndrome-patient-and-control-human-pluripotent-stem-cell-derived-cardiac-clusters
#2
Duncan C Miller, Stephen C Harmer, Ariel Poliandri, Muriel Nobles, Elizabeth C Edwards, James S Ware, Tyson V Sharp, Tristan R McKay, Leo Dunkel, Pier D Lambiase, Andrew Tinker
The class Ia anti-arrhythmic drug ajmaline is used clinically to unmask latent type I ECG in Brugada syndrome (BrS) patients, although its mode of action is poorly characterised. Our aims were to identify ajmaline's mode of action in human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes (CMs), and establish a simple BrS hiPSC platform to test whether differences in ajmaline response could be determined between BrS patients and controls. Control hiPSCs were differentiated into spontaneously contracting cardiac clusters...
November 7, 2017: Stem Cell Research
https://www.readbyqxmd.com/read/29038108/ajmaline-induced-slowing-of-conduction-in-the-right-ventricular-outflow-tract-cannot-account-for-st-elevation-in-patients-with-type-i-brugada-ecg
#3
EDITORIAL
Charles Antzelevitch, Bence Patocskai
No abstract text is available yet for this article.
October 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29038102/st-elevation-magnitude-correlates-with-right-ventricular-outflow-tract-conduction-delay-in-type-i-brugada-ecg
#4
Kevin M W Leong, Fu Siong Ng, Cheng Yao, Caroline Roney, Patricia Taraborrelli, Nicholas W F Linton, Zachary I Whinnett, David C Lefroy, D Wyn Davies, Phang Boon Lim, Sian E Harding, Nicholas S Peters, Prapa Kanagaratnam, Amanda M Varnava
BACKGROUND: The substrate location and underlying electrophysiological mechanisms that contribute to the characteristic ECG pattern of Brugada syndrome (BrS) are still debated. Using noninvasive electrocardiographical imaging, we studied whole heart conduction and repolarization patterns during ajmaline challenge in BrS individuals. METHODS AND RESULTS: A total of 13 participants (mean age, 44±12 years; 8 men), 11 concealed patients with type I BrS and 2 healthy controls, underwent an ajmaline infusion with electrocardiographical imaging and ECG recordings...
October 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28948234/mechanisms-underlying-epicardial-radiofrequency-ablation-to-suppress-arrhythmogenesis-in-experimental-models-of-brugada-syndrome
#5
Bence Patocskai, Namsik Yoon, Charles Antzelevitch
OBJECTIVES: This study sought to test the hypothesis that elimination of sites of abnormal repolarization, via epicardial RFA, suppresses the electrocardiographic and arrhythmic manifestations of BrS. BACKGROUND: Brugada syndrome (BrS) is associated with ventricular tachycardia and ventricular fibrillation leading to sudden cardiac death. Nademanee et al. reported that radiofrequency ablation (RFA) of right ventricular outflow tract epicardium significantly reduced the electrocardiogram and arrhythmic manifestations of BrS...
April 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28877999/sudden-cardiac-arrest-while-eating-a-hot-dog-a-rare-presentation-of-brugada-syndrome-in-a-child
#6
Isa Ozyilmaz, Bedir Akyol, Yakup Ergul
Patients who are diagnosed with Brugada syndrome (BS) usually experience sudden cardiac arrest (SCA) and arrhythmia when they have a high fever, consume alcohol, and, more frequently, during their night sleep. In some rare cases, an SCA can be seen depending on a possible vagal stimulus, such as eating a large bite of food. We describe a 9-year-old patient who had a sudden cardiac attack while he was eating a large hot dog. After successful resuscitation, a suspicious ST elevation in V2 was seen in his electrocardiographic evaluation...
October 2017: Pediatrics
https://www.readbyqxmd.com/read/28781860/masquerading-bundle-branch-block-obscuring-the-diagnosis-of-brugada-syndrome-an-electrocardiographic-and-vectorcardiographic-study
#7
Isabel V Konopka, Hugo A Garro, Rita B Tepper, Norma Pizzarelli, Mario D Gonzalez, Rafael S Acunzo
We describe the induction of a masquerading bundle branch block in two patients with Brugada syndrome following the administration of Ajmaline. The development of this conduction disturbance prevented the correct electrocardiographic diagnosis. However, the simultaneously obtained vectocardiogram identified both the Brugada pattern and the masquerading bundle branch block.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28666944/sodium-channel-blocker-challenge-in-the-familial-screening-of-brugada-syndrome-safety-and-predictors-of-positivity
#8
Dylan Therasse, Frederic Sacher, Bertrand Petit, Dominique Babuty, Philippe Mabo, Raphael Martins, Laurence Jesel, Philippe Maury, Jean Luc Pasquie, Jacques Mansourati, Jean Marc Dupuis, Florence Kyndt, Aurélie Thollet, Beatrice Guyomarch, Julien Barc, Jean Jacques Schott, Herve Le Marec, Richard Redon, Vincent Probst, Jean-Baptiste Gourraud
BACKGROUND: Sodium-channel blocker challenge (SCBC) is frequently performed to unmask Brugada syndrome. OBJECTIVE: We aim to identify predictors of positivity and complications of SCBC in the setting of familial screening of Brugada syndrome. METHODS: All consecutive patients from 2000 to 2014 who benefit from a sodium-channel blocker and belong to a family with at least 2 subjects affected by the syndrome were enrolled and followed prospectively...
October 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28654178/dual-catalytic-activity-of-a-cytochrome-p450-controls-bifurcation-at-a-metabolic-branch-point-of-alkaloid-biosynthesis-in-rauwolfia-serpentina
#9
Thu-Thuy T Dang, Jakob Franke, Evangelos Tatsis, Sarah E O'Connor
Plants create tremendous chemical diversity from a single biosynthetic intermediate. In plant-derived ajmalan alkaloid pathways, the biosynthetic intermediate vomilenine can be transformed into the anti-arrhythmic compound ajmaline, or alternatively, can isomerize to form perakine, an alkaloid with a structurally distinct scaffold. Here we report the discovery and characterization of vinorine hydroxylase, a cytochrome P450 enzyme that hydroxylates vinorine to form vomilenine, which was found to exist as a mixture of rapidly interconverting epimers...
August 1, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/28521022/management-of-untreatable-ventricular-arrhythmias-during-pharmacologic-challenges-with-sodium-channel-blockers-for-suspected-brugada-syndrome
#10
Stefano Poli, Mauro Toniolo, Massimo Maiani, Davide Zanuttini, Luca Rebellato, Igor Vendramin, Ermanno Dametto, Guglielmo Bernardi, Flavio Bassi, Carlo Napolitano, Ugolino Livi, Alessandro Proclemer
Pharmacologic challenge with sodium channel blockers is part of the diagnostic workout in patients with suspected Brugada syndrome. The test is overall considered safe but both ajmaline and flecainide detain well known pro-arrhythmic properties. Moreover, the treatment of patients with life-threatening arrhythmias during these diagnostic procedures is not well defined. Current consensus guidelines suggest to adopt cautious protocols interrupting the sodium channel blockers as soon as any ECG alteration appears...
May 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28500178/electrical-substrate-elimination-in-135-consecutive-patients-with-brugada-syndrome
#11
Carlo Pappone, Josep Brugada, Gabriele Vicedomini, Giuseppe Ciconte, Francesco Manguso, Massimo Saviano, Raffaele Vitale, Amarild Cuko, Luigi Giannelli, Zarko Calovic, Manuel Conti, Paolo Pozzi, Andrea Natalizia, Simonetta Crisà, Valeria Borrelli, Ramon Brugada, Georgia Sarquella-Brugada, Marco Guazzi, Alessandro Frigiola, Lorenzo Menicanti, Vincenzo Santinelli
BACKGROUND: There is emerging evidence that localization and elimination of abnormal electric activity in the epicardial right ventricular outflow tract may be beneficial in patients with Brugada syndrome. METHODS AND RESULTS: A total of 135 symptomatic Brugada syndrome patients having implantable cardiac defibrillator were enrolled: 63 (group 1) having documented ventricular tachycardia (VT)/ventricular fibrillation (VF) and Brugada syndrome-related symptoms, and 72 (group 2) having inducible VT/VF without ECG documentation at the time of symptoms...
May 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28436550/epicardial-brugada-syndrome-ablation-unmasking-inferior-j-waves
#12
Adam Lee, Heidi Kohler, Daniel Wright, Haris M Haqqani
Patients with Brugada syndrome are at risk of life-threatening ventricular arrhythmias. Epicardial substrate ablation for Brugada syndrome has been described as a means of controlling these arrhythmias and recent reports describe elimination of the Brugada phenotype with ablation. We describe a unique case in which a patient developed inferior J waves with an early repolarization-type electrocardiogram following successful epicardial infundibular substrate ablation (which eliminated the Brugada syndrome electrocardiogram on ajmaline challenge)...
November 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28419221/should-all-individuals-with-a-non-diagnostic-electrocardiogram-undergo-ajmaline-challenge-to-unmask-the-concealed-arrhythmic-overlap-syndromes
#13
Ahmet Vedat Kavurt, Ozcan Ozeke, Serkan Cay, Serkan Topaloglu, Dursun Aras
No abstract text is available yet for this article.
October 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28381391/brugada-phenocopy-induced-by-propafenone-overdose-and-successful-treatment-a-case-report
#14
Mehmet Emre Arı, Filiz Ekici
BACKGROUND: Brugada syndrome is an inherited arrhythmogenic disease that may cause sudden cardiac death due to ventricular fibrillation in young adults. Brugada syndrome caused by propafenone intoxication has been noted rarely in the literature. We report a rare case, Brugada phenocopy due to propafenone intoxication and its treatment. CASE REPORT: A 15-year-old girl having a seizure was brought to the emergency room. She took 1.5 g propafenone (Rythmol, Abbott, Chicago, IL, USA) for suicidal intention...
September 29, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28344931/proarrhythmogenic-effects-of-lamotrigine-during-ajmaline-testing-for-brugada-syndrome
#15
Kevin M W Leong, Henry Seligman, Amanda M Varnava
No abstract text is available yet for this article.
March 2017: HeartRhythm Case Reports
https://www.readbyqxmd.com/read/28340026/high-rate-of-subcutaneous-implantable-cardioverter-defibrillator-sensing-screening-failure-in-patients-with-brugada-syndrome-a-comparison-with-other-inherited-primary-arrhythmia-syndromes
#16
Giulio Conte, Mihoko Kawabata, Carlo de Asmundis, Erika Taravelli, Francesco Petracca, Diego Ruggiero, Maria Luce Caputo, François Regoli, Gian-Battista Chierchia, Alessandra Chiodini, Alessandro Del Bufalo, Tiziano Moccetti, Masahiko Goya, Kenzo Hirao, Alessandro Vicentini, Gaetano M De Ferrari, Pedro Brugada, Angelo Auricchio
Aims: Subcutaneous implantable cardioverter-defibrillator (S-ICD) can avoid important complications associated with transvenous leads in patients with inherited primary arrhythmia syndromes, who do not need pacing therapy. Few data are available on the percentage of patients with inherited arrhythmia syndromes eligible for S-ICD implantation. Aim of this study was to analyse the eligibility for S-ICD in a series of patients with Brugada syndrome (BrS), and to compare it with patients with other channelopathies...
March 7, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27915266/systematic-ajmaline-challenge-in-patients-with-long-qt-3-syndrome-caused-by-the-most-common-mutation-a-multicentre-study
#17
Stephan Hohmann, Boris Rudic, Torsten Konrad, David Duncker, Thorben König, Erol Tülümen, Thomas Rostock, Martin Borggrefe, Christian Veltmann
Aims: Overlap syndromes of long QT 3 syndrome (LQT3) and the Brugada syndrome (BrS) have been reported. Identification of patients with an overlapping phenotype is crucial before initiation of Class I antiarrhythmic drugs for LQT3. Aim of the present study was to elucidate the yield of ajmaline challenge in unmasking the Brugada phenotype in patients with LQT3 caused by the most common mutation, SCN5A-E1784K. Methods and results: Consecutive families in tertiary referral centres diagnosed with LQT3 caused by SCN5A-E1784K were included in the study...
October 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27909532/ajmaline-challenge-to-unmask-infrahisian-disease-in-patients-with-recurrent-and-unexplained-syncope-preserved-ejection-fraction-with-or-without-conduction-abnormalities-on-surface-ecg
#18
Francesco Pentimalli, Luca Bacino, Matteo Ghione, Siri Giambattista, Massimo Gazzarata, Paolo Bellotti
Background: Pharmacological challenge with class I antiarrhythmic drug is a recommended diagnostic test in patients with unexplained syncope only in the presence of bundle branch block, when non-invasive tests have failed to make the diagnosis. Its role in patients with minor or no conduction disturbances on 12-leads ECG has not been evaluated yet. It is also not clear which are the values of His-Ventricular interval to be considered diagnostic. We sought to evaluate the role of ajmaline challenge in unmasking the presence of an infrahisian disease in patients with recurrent and unexplained syncope, regardless of the existence of conduction disturbances on surface ECG...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909514/influence-of-novel-electrocardiographic-features-of-provocable-brugada-ecg-in-arrhythmogenic-cardiomyopathy-and-its-exclusion-by-lead-avr
#19
REVIEW
Stefan Peters
In 19 patients (14 females, mean age 49.1 ± 11.3 years) with typical arrhythmogenic cardiomyopathy and provocable type I Brugada ECG pattern by ajmaline administration were analysed by novel electrocardiographic features as having "true" or "false" Brugada syndrome. Three patients turned out as having false Brugada syndrome, the diagnosis is pure arrhythmogenic cardiomyopathy. In 16 patients, however, true Brugada syndrome could be provoked. In these patients the diagnosis was arrhythmogenic cardiomyopathy associated by provocable Brugada syndrome...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27854259/synthesis-of-bisindole-alkaloids-from-the-apocynaceae-which-contain-a-macroline-or-sarpagine-unit-a-review
#20
REVIEW
Md Toufiqur Rahman, Veera V N Phani Babu Tiruveedhula, James M Cook
Bisindole natural products consist of two monomeric indole alkaloid units as their obligate constituents. Bisindoles are more potent with respect to their biological activity than their corresponding monomeric units. In addition, the synthesis of bisindoles are far more challenging than the synthesis of monomeric indole alkaloids. Herein is reviewed the enantiospecific total and partial synthesis of bisindole alkaloids isolated primarily from the Alstonia genus of the Apocynaceae family. The monomeric units belong to the sarpagine, ajmaline, macroline, vobasine, and pleiocarpamine series...
November 14, 2016: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
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