DX ICD Implanted After Unmasking Brugada – A Case Study

Dr. T. Joseph

Consultant Interventional Cardiologist and Electrophysiologist, Kauvery Hospital, Trichy-Heartcity, India

Case Presentation

A 42-years-old male presented to OPD for giddiness.

Family history of two RTA related deaths.

Elder brother died three months back while driving speaking on mobile phone.

ECG atypical RBB with sinus brady cardia

Flecainide challenge test done under close supervision.

ECG

DX-ICD-1

Fig 1. Baseline ECG.

Interventions

Oral flecainide 400 mg stat given and patient developed typical Type 1 Brugada with flurry of VPS (Fig. 2).

DX-ICD-2

Fig. 2. Flecainide Challenge Induced Brugada.

DX ICD was implanted as part of primary prevention.

Dx ICD is single pass VDD ICD which contains a floating atrial electrode in right atrium (Fig. 3).

DX-ICD-3

Fig. 3. Dx ICD.

Acknowledgement

All Credit goes to meticulous history taking by our medical officers (Drs. Jeevitha and Siddharth) and diligent care of CCU nurses during the entire flecainide challenge test.

Dr.-T.-Joseph

Dr. T. Joseph

Consultant Interventional Cardiologist & Electrophysiologist

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