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BRUGADA
SYNDROME AND ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY
Ahammed Siraj
Post Graduate Student in Medicine
Calicut Medical College
Address
for Correspondence:
Dr Ahammed Siraj
PG Student,
Dept of Medicine,
Calicut Medical College,Calicut-673008
Kerala,India
E-Mail: drcasiraj@rediffmail.com
The review by Francis et. al [1] highlights the various aspects of
Brugada
Syndrome including the risk of sudden cardiac death and the various
conditions mimicking the electrocardiographic (ECG) patterns. An
important inherited entity with similar ECG findings and often no
detectable structural abnormalities is Arrhythmogenic right
ventricular cardiomyopathy (ARVC) which is also associated with
fatal ventricular arrhythmias.[2]The replacement of myocardium with
fatty tissue in ARVC may be detected only at autopsy.[2]A drug
challenge with sodium channel blockers can be useful in
differentiating ARVC from Brugada syndrome. A rightward shift of e
wave ,if any, can help a more positive diagnosis of ARVC. [3] Sodium
channel blockers are also relevant in their property of unmasking
the ECG findings in Brugada syndrome.[1,2]The right bundle branch
block(RBBB) pattern in Brugada syndrome may be due to an early
repolarisation of the right ventricular epicardium rather than a
conduction block in the right bundle of His.[4]The wide S waves in
lead I , aVL and V6 that are classically seen in true RBBB are
usually absent.[2]But,various conduction abnormalities are described
in Brugada syndrome including a true RBBB with or with out right
axis deviation.[3]
References:
1.Francis J,Sajeev CG,Venugopal K. Brugada Syndrome: The Enigma.
Calicut Medical Journal 2003; 1(1):e3 .
URL: http://www.calicutmedicaljournal.org/2003;1(1)e3.htm
2.Kyuhyun Wang, Richard W Asinger, Henry J L Marriott.ST-segment
Elevation in conditions other than Acute Myocardial Infarction.
N Engl J Med 2003;349:2128-35
3.Arthur A M Wilde, Charles Antzelevitch,Martin Borggrefe et. al.
Proposed Diagnostic Criteria for the Brugada Syndrome.Consensus
report.
Circulation 2002;106:2514-2519
4.Charles Antzelevitch, Pedro Brugada, Josep Brugada et. al.Brugada
syndrome.1992-2002. A Historical Perspective. J Am Coll Cardiol
2003;41:1665-71
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