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Catheter Ablation for Brugada Syndrome
  • +4
  • Dingxin Qin,
  • Weeranun Bode,
  • E. Heist,
  • Steven Lubitz,
  • Pasquale Santangeli,
  • Jeremy Ruskin,
  • Moussa Mansour
Dingxin Qin
Massachusetts General Hospital
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Weeranun Bode
Massachusetts General Hospital
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E. Heist
Massachusetts General Hospital
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Steven Lubitz
Massachusetts General Hospital
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Pasquale Santangeli
Hospital of the University of Pennsylvania
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Jeremy Ruskin
Massachusetts General Hospital
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Moussa Mansour
Massachusetts General Hospital
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Abstract

We report a case of catheter ablation of Brugada syndrome (BrS) in a patient with refractory ventricular fibrillation (VF) despite quinidine therapy. We performed epicardial substrate mapping which identified an area of abnormal fractionated, prolonged electrogram in the anterior right ventricular outflow tract. Warm saline infusion into the pericardial space induced further delay of the local electrogram, consistent with BrS physiology. Coronary angiogram confirmed the area was distant from major coronary arteries. Ablation was performed in this area which eliminated local abnormal electrograms and led to the disappearance of coved-type ST elevation in V1-V2. No VF recurred at 3-month follow-up.