Answer DV Case 6

The original ECG, is the typical cove type Brugada syndrome ECG. Often this type of ECG is confusing when an acute anterior myocardial infarct is suspected. This patient received amiodarone. The prolongation of the QT interval is noticeable on the second tracing. Also note the rapid change in QRS configuration. The configuration however, is still suggestive for Brugada syndrome. Proper treatment of the repetitive VT induced by fever, was instituted by sedation and cooling of the patient. Amiodarone was stopped as it is not the drug of choice in Brugada syndrome. When temperature was lowered to < 37° C , VF did not recur. A week later an ICD was implanted.