Ablative therapy in a case ofBrugada syndromewith an electrical storm

Abstract

Patients with Brugada syndrome may have malignant ventricular arrhythmias and sudden cardiac death. Thus, these patients frequently have indication of implantable cardioverter defibrillator. Occasionally, these patients may experience recurrent appropriate cardioverter defibrillator shocks refractory to medical treatment. Recent reports indicate that radiofrequency ablation in Brugada syndrome is feasible, and effective.
A 55-year-old woman with Brugada syndrome and an electrical storm, underwent three-dimensional electroanatomic mapping and radiofrequency ablation. During electrophysiological study there were no spontaneous or inducible arrhythmias. Voltage mapping of the right ventricle was created in sinus rhythm and both, endocardial and epicardial substrate modification of right ventricular outflow tract was performed. Brugada ECG pattern resolved post procedure.
Follow up at 4 months revealed no recurrence of ventricular arrhythmias or Brugada electrocardiographic pattern.
Radiofrequency mediated therapy for substrate modification in patients with Brugada syndrome and an electrical
storm, may be useful in their critical care management.