Heart 1998;79:305-307 ( March )
Case report
Bifid T waves induced by isoprenaline in a patient with Brugada
syndrome
First Department of Internal Medicine, Niigata
University School of Medicine, Asahimachi 1-754, Niigata 951, Japan
Correspondence to: Dr Washizuka. email: washi{at}med.niigata-u.ac.jp
Accepted for publication 4 November 1997
A 41 year old man with incomplete right bundle branch block and
persistent coved-type ST elevation in the right precordial leads during
sinus rhythm had an episode of syncope while driving. He had never had
syncope before and there was no family history of sudden cardiac death.
Ventricular fibrillation was induced during electrophysiological study
(EPS) by double extrastimuli applied to the right ventricle.
Disopyramide was effective in preventing ventricular fibrillation
during EPS. 
Adrenoceptor stimulation manifested bifid T waves and
reduced ST segment elevation in right precordial leads. Simultaneously
recorded monophasic action potential (MAP) duration at 90%
repolarisation did not change in the right ventricular outflow tract,
while it shortened in the left ventricular septum. These findings
suggest that right precordial bifid T waves might result from
relatively early repolarisation of the left ventricles. Moreover the
gradient of action potential duration might explain the mechanism of ST
segment abnormalities in a patient with Brugada syndrome.
© 1998 by Heart
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This article has been cited by other articles:
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Bianco, M, Bria, S, Gianfelici, A, Sanna, N, Palmieri, V, Zeppilli, P
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[Abstract] -
LITTMANN, L.
(1998). Bifid T waves induced by isoprenaline in a patient with Brugada syndrome. Heart
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