alexa Anesthetic management of a patient with brugada syndrome - the use of sugammadex in major abdominal surgery


Journal of General Practice

Author(s): Rita Conde, Marta Pereira

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Brugada Syndrome (BS) is a rare genetic condition affecting ionic channels of the heart, predisposing patients to potentially fatal ventricular arrhythmias. It generally manifests during young adulthood, more frequently in males. Typical ECG pattern shows ST-segment elevation followed by a negative T wave in right pre-cordial leads, in the absence of structural heart disease. Three patterns can be recognized: 1) coved; 2) saddleback and 3) coved or saddleback with ST < 1 mm. These can co-exist and ECG may be temporarily normal. Diagnosis is made in the presence of ECG pattern type 1 and reinforced by clinical criteria like syncope, nocturnal agonal respiration, palpitations or dizziness, documented ventricular fibrillation/tachycardia and family history of BS or sudden cardiac death (SCD). Provocative tests can be made with sodium channel blockers. Cardiac defibrillator (ICD) implantation is recommended for all symptomatic patients and for those who, though asymptomatic, present inducible VT/VF during electrophysiologic study (EPS). Quinidine can be used safely as anti-arrhythmic agent when ICD implantation is not possible

This article was published in Revista Brasileira de Anestesiologia and referenced in Journal of General Practice

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