Anesth Analg 2006;102:233-236
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000184258.64205.9B
CRITICAL CARE AND TRAUMA
Unmasking of Brugada Syndrome by an Antiarrhythmic Drug in a Patient with Septic Shock
Katsuyuki Terajima, MD,
Takesi Yamamoto, MD,
Hidetaka Onodera, MD,
Shinhiro Takeda, MD,
Keiji Tanaka, MD, and
Atsuhiro Sakamoto, MD
Division of Intensive Care and Coronary Care Unit, Nippon Medical School, Tokyo, Japan
Address correspondence and reprint requests to Katsuyuki Terajima, 115 Sendagi, Bunkyo-ku, Tokyo, 1138603, Japan. Address e-mail to terajima.katsuyuki{at}nifty.com.
Asymptomatic Brugada syndrome patients often display concealed Brugada-type electrocardiogram patterns that result in under-diagnosis of this syndrome. These patients include individuals of both genders and a wide range of ages. They are as likely as non-Brugada patients to have normal longevity or to suffer from a critical illness. Here we report a case of septic shock in which Brugada-type electrocardiogram patterns were induced by pilsicainide administration for the treatment of atrial fibrillation. This case report suggests that some drugs used in the treatment of septic shock can unmask the Brugada-type electrocardiogram pattern and induce lethal ventricular tachyarrhythmia.
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