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The Brugada syndrome is characterized by a ST-segment elevation in the right precordial leads associated with right bundle branch block (RBBB) pattern and a propensity for life-threatening ventricular arrhythmias in the absence of structural heart disease.1 Mutations in a cardiac sodium channel gene have been linked to this syndrome2. The mechanism underlying the RBBB and ST-segment elevation in right precordial leads in patients with the Brugada syndrome is thought to be an outward shift of the ionic currents during early repolarization causing a marked accentuation of the action potential notch in right ventricular epicardial but not endocardial cells. The outward shift of current ultimately leads to loss of the action potential dome causing marked abbreviation of the action potential in the right ventricular epicardial cells.3, 4,5 Local pressure applied to the right ventricular wall has also been reported to induce an ECG pattern similar to the Brugada syndrome. Tarin et al reported a patient with a mediastinal tumor and electrocardiographic findings similar to those described in the Brugada syndrome. This ECG pattern disappeared after tumor removal, thus suggesting that it was probably caused by compression of the right ventricular outflow tract by the mass.6 Another case of pericardial fluid and tumour compressing the right ventricle with Brugada-like ECG pattern in a patient with rheumatoid arthritis has also been reported7 During surgery the tumour was found to be organised haemopericardium. After the surgery the patient was well and had a normal ECG.