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. 2006 Jul;27(13):1579-83.
doi: 10.1093/eurheartj/ehl060. Epub 2006 Jun 7.

Low-dose Isoproterenol for Repetitive Ventricular Arrhythmia in Patients With Brugada Syndrome


Low-dose Isoproterenol for Repetitive Ventricular Arrhythmia in Patients With Brugada Syndrome

Atsuyuki Watanabe et al. Eur Heart J. .


Aims: Arrhythmic storm or repetitive ventricular arrhythmia (VA) has been occasionally observed in Brugada syndrome (BS). A beta-adrenergic stimulator [isoproterenol (ISP)] has been reported to suppress this arrhythmic storm in sporadic cases. Accordingly, we investigated the antiarrhythmic effects of ISP infusion in consecutive BS patients with arrhythmic storm or repetitive VA.

Methods and results: Seven BS patients with arrhythmic storm were studied. Intravenous ISP was administered as a bolus injection (1-2 microg), followed by continuous infusion (0.15 microg/min). Arrhythmic storm or repetitive VA was suppressed immediately after the bolus administration of ISP, which was followed by continuous infusion of low-dose ISP for 1-3 days. In all patients, ST-elevation decreased in right precordial leads. In six of the seven patients, VA subsided after the discontinuance of ISP. RR interval was shortened and ST-elevation in right precordial leads was decreased after ISP bolus injection. ST-elevation in right precordial leads remained decreased during continuous ISP infusion, whereas the RR interval returned to the control level.

Conclusion: Continuous administration of low-dose ISP may be effective for the suppression of repetitive VA occurrence in patients with BS.

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