Catheter Ablation for Brugada Syndrome.

We report a case of catheter ablation of Brugada syndrome in a patient with refractory ventricular fibrillation 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 Brugada syndrome physiology. Coronary angiography confirmed that 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 ventricular fibrillation had recurred by five months of follow-up.

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Copyright: © 2021 Innovations in Cardiac Rhythm Management.

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Dr. Heist receives consulting fees from Abbott, Boston Scientific, Medtronic, and Pfizer; research grants from Abbott, Biotronik, and Pfizer; and honoraria from Medtronic, Biotronik, and Abbott. Dr. Lubitz is supported by a National Institutes of Health grant (1R01HL139731) and an American Heart Association grant (18SFRN34250007); receives sponsored research support from Bristol Myers Squibb/Pfizer, Bayer AG, Boehringer Ingelheim, and Fitbit; and has consulted for Bristol Myers Squibb/Pfizer and Bayer AG. Dr. Santangeli is a consultant for Abbott, Biosense Webster, and Baylis and has receive research grants from Biosense Webster and Attune Medical. Dr. Ruskin has served as a consultant for Acesion Pharma, Advanced Medical Education, Correvio, Hanover Medical, InCarda, Janssen, LuxCath, Medtronic, Novartis, and Pfizer and has equity interests in Ablacor, Celero Systems, Element Science, Gilead, Infobionic, NewPace, and Portola. Dr. Mansour has served as a consultant for Biosense Webster, Abbott, Medtronic, Boston Scientific, Janssen, Philips, Novartis, Baylis, and SentreHeart; has received research grants from Biosense Webster, Abbott, Boston Scientific, Medtronic, Pfizer, and Boehringer Ingelheim; and has equity interests in EPD Solutions, NewPace, and Affera. The other authors report no conflicts of interest for the published content.