The Korean Journal of Medicine

  • 제86권1호
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  • Pages.70-73
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  • 2014
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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심방 세동 환자에게 propafenone 투여 후 발현된 Brugada 심전도 패턴 1예

A Concealed Brugada Electrocardiogram Pattern Revealed after Administering Propafenone to a Patient with Atrial Fibrillation

  • Sim, Hyoung Hun (Department of Internal Medicine, National Police Hospital) ;
  • Kwon, Nak Hyun (Department of Internal Medicine, National Police Hospital) ;
  • Baeg, Joo Yeong (Department of Internal Medicine, National Police Hospital) ;
  • Yun, Chang Yong (Department of Internal Medicine, National Police Hospital) ;
  • Ahn, Soo Min (Department of Internal Medicine, National Police Hospital) ;
  • Oh, Yu Mi (Department of Internal Medicine, National Police Hospital) ;
  • Kim, Young Jung (Department of Internal Medicine, National Police Hospital)
  • 투고 : 2013.01.03
  • 심사 : 2013.03.05
  • 발행 : 2014.01.01
⟨ 이전 논문 다음 논문 ⟩

초록

Brugada 증후군은 구조적 심질환이 없는 환자에게서 발생하는 심실성 부정맥과 연관된 돌연사를 특징으로 한다. 저자 등은 실신을 주소로 내원한 환자의 심방 세동 치료를 위해 propafenone 투약 후 숨겨져 있던 Brugada 심전도 패턴이 드러난 증례를 경험하였다. 실신을 경험한 34세의 남자 환자가 급성 심방 세동으로 응급실로 내원하였으며 propafenone 300 mg 투여 후 Brugada type 1 심전도 패턴이 발현되어 이를 보고하는 바이다.

Brugada syndrome is characterized by sudden cardiac death associated with ventricular tachyarrhythmia in patients without structural heart disease. We recently observed a case of concealed Brugada ECG pattern, which appeared after oral propafenone administration for atrial fibrillation. A 34-year-old male patient who experienced syncope was admitted to the emergency department with acute atrial fibrillation (AF). Three hundred milligrams of propafenone that were administered to convert AF to sinus rhythm unmasked the Brugada ECG pattern that had remained concealed. The patient showed a type 1 Brugada ECG pattern after taking propafenone.

키워드

참고문헌

  1. Antzelevitch C, Brugada P, Borggrefe M, et al. Brugada syndrome: report of the second consensus conference: endorsed by the Heart Rhythm Society and the European Heart Rhythm Association. Circulation 2005;111:659-670. https://doi.org/10.1161/01.CIR.0000152479.54298.51
  2. Lee JB, Lee MY, Lee SJ, et al. Unmasking of the idiopathic Brugada electrocardiogram pattern in a febrile patient with pneumonia. Korean J Med 2011;80(Suppl 2):S166-171.
  3. Yan GX, Antzelevitch C. Cellular basis for the Brugada syndrome and other mechanisms of arrhythmogenesis associated with ST-segment elevation. Circulation 1999;100:1660-1666. https://doi.org/10.1161/01.CIR.100.15.1660
  4. Brugada J, Brugada P. Further characterization of the syndrome of right bundle branch block, ST segment elevation, and sudden cardiac death. J Cardiovasc Electrophysiol 1997;8:325-331. https://doi.org/10.1111/j.1540-8167.1997.tb00796.x
  5. Matana A, Goldner V, Stanic K, Mavric Z, Zaputovic L, Matana Z. Unmasking effect of propafenone on the concealed form of the Brugada phenomenon. Pacing Clin Electrophysiol 2000;23:416-418. https://doi.org/10.1111/j.1540-8159.2000.tb06774.x
  6. Bordachar P, Reuter S, Garrigue S, et al. Incidence, clinical implications and prognosis of atrial arrhythmias in Brugada syndrome. Eur Heart J 2004;25:879-884. https://doi.org/10.1016/j.ehj.2004.01.004
  7. Kusano KF, Taniyama M, Nakamura K, et al. Atrial fibrillation in patients with Brugada syndrome relationships of gene mutation, electrophysiology, and clinical backgrounds. J Am Coll Cardiol 2008;51:1169-1175. https://doi.org/10.1016/j.jacc.2007.10.060
  8. Klein G, Gardiwal A, Schaefer A, Panning B, Breitmeier D. Effect of ethanol on cardiac single sodium channel gating. Forensic Sci Int 2007;171:131-135. https://doi.org/10.1016/j.forsciint.2006.10.012
  9. Hayashi T, Mitani H, Goto K, et al. Alcohol-induced ventricular fibrillation in Brugada syndrome. J Arrhythmia 2009;25:32-35. https://doi.org/10.1016/S1880-4276(09)80031-8
  10. Pinski SL, Helguera ME. Antiarrhythmic drug initiation in patients with atrial fibrillation. Prog Cardiovasc Dis 1999;42:75-90. https://doi.org/10.1016/S0033-0620(99)70010-1