BRUGADA SYNDROME AND SINUS NODE DYSFUNCTION: CASE STUDY

Abstract

Introduction

Brugada syndrome is due to calcium channels dysfunction that can be responsible for serious ventricular disorders and conduction abnormalities.

Observation

It was a 37-year-old man, who had been seen for bradycardia. The interrogation found a notion of undocumented loss of consciousness at the age of 17 consecutive to an effort. Blood pressure was at 150/70 mmHg and the heart rate was 42 bpm. The physical examination was featureless apart from bradycardia. The electrocardiogram recorded a straight branch block aspect, an ST segment elevation in straight precordial leads (V1 to V3), and sinus pauses. The Doppler echocardiography was normal. The Holter monitor showed sinus pauses, the longest one lasting 6095 ms. No rhythm disorder was noted during the 24 hours. Electrophysiological exploration showed an extension of the AH intervals at 140 ms and HV at 70 ms. The corrected sinus recovery time was calculated at 3772 ms. Luciani Wenckebach's time was measured at 480 ms and the point 2/1 at 450 ms. The programmed ventricular pacing had not triggered ventricular arrhythmia. The patient benefited an implantable cardioverter defibrillator (ICD). The evolution was good at 3 months with control of the ICD parameters. Genetical analysis was not done due to lack of financial ressources. A clinical family survey is in progress.

Conclusion

The association Brugada syndrome and sinus node dysfunction is not uncommon. Only the implantation of an ICD is an approved therapy.