Korean Circ J.  2000 May;30(5):611-616. 10.4070/kcj.2000.30.5.611.

Two cases of sudden cardiac death syndrome associated with right bundle branch block and ST segment elevation

• Park SS
• Nam GB
• Choi KJ
• Song JK
• Kim JJ
• Park SJ
• Park JH
• Kim YH

• KMID: 2145651
• DOI: http://doi.org/10.4070/kcj.2000.30.5.611

Abstract

In 1992, Brugada described clinical features of patients with aborted sudden cardiac death who showed no demonstrable heart disease and a peculiar ECG pattern consisting of right bundle branch block and ST-segment elevation in right precordial leads. Recently, We experienced two cases with aborted sudden cardiac death and similar ECG pattern. Physical examination, routine laboratory tests including serum electrolytes, echocardiography, myocardial thallium SPECT, MRI and MIBG scans were within normal limit. Arrhythmias were not induced in treadmill exercise test, and signal averaged ECGs revealed positive late potentials. Coronary angiography showed normal coronary artery with no evidence of induced vasospasm. Polymorphic ventricular tachycardia and ventricular fibrillation were induced by ventricular stimulation. Intravenous administration of flecainide, procainamide augmented ST segment elevation in one patient, and isoproterenol reduced ST segment elevation in the other patient. For prevention of sudden death, ICDs were implanted in the two patients. Ventricular fibrillations occurred in one patient 12 and 13 months after the implantation and were successfully terminated by ICD.

MeSH Terms

3-Iodobenzylguanidine
Administration, Intravenous
Arrhythmias, Cardiac
Bundle-Branch Block*
Coronary Angiography
Coronary Vessels
Death, Sudden
Death, Sudden, Cardiac*
Echocardiography
Electrocardiography
Electrolytes
Exercise Test
Flecainide
Heart Diseases
Humans
Isoproterenol
Magnetic Resonance Imaging
Physical Examination
Procainamide
Tachycardia, Ventricular
Thallium
Tomography, Emission-Computed, Single-Photon
Ventricular Fibrillation
3-Iodobenzylguanidine
Electrolytes
Flecainide
Isoproterenol
Procainamide
Thallium