Long-term pharmacological therapy of Brugada syndrome: is J-wave attenuation a marker of drug efficacy?

Intern Med. 2014;53(14):1523-6. doi: 10.2169/internalmedicine.53.1829. Epub 2014 Jul 15.

Abstract

We herein describe two patients with Brugada syndrome in whom J-waves were successfully modified by drugs. Case 1 was a 54-year-old man who presented with repeated ventricular fibrillations (VF) and J-point elevation in the right precordial and lateral leads. After administration of cilostazol (200 mg/d), J-waves disappeared and coved-type ST-segment elevation changed to a saddleback-type for 25 months. Case 2 was a 31-year-old man who presented with a VF storm and J-point elevation in the lateral leads. After administration of quinidine (300 mg/d), J-waves and coved-type ST-segment elevation disappeared for 20 months. J-wave disappearance and coved-type ST-segment elevation were followed by VF suppression, probably due to transient outward potassium current (Ito) suppression.

Publication types

  • Case Reports

MeSH terms

  • Anti-Arrhythmia Agents / administration & dosage
  • Arrhythmias, Cardiac / physiopathology*
  • Brugada Syndrome / drug therapy*
  • Brugada Syndrome / physiopathology
  • Cardiac Conduction System Disease
  • Cilostazol
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Electrocardiography / drug effects*
  • Follow-Up Studies
  • Heart Conduction System / abnormalities*
  • Heart Conduction System / drug effects
  • Heart Conduction System / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Phosphodiesterase 3 Inhibitors / administration & dosage
  • Quinidine / administration & dosage*
  • Tetrazoles / administration & dosage*
  • Time Factors

Substances

  • Anti-Arrhythmia Agents
  • Phosphodiesterase 3 Inhibitors
  • Tetrazoles
  • Quinidine
  • Cilostazol