PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item Electrocardiographic Variables Associated With Underlying Brugada Syndrome Or Drug-Induced Type 1 Brugada Pattern In Patients With Slow/Fast Atrioventricular Nodal Reentrant Tachycardia(2022) Hasdemir, Can; Sahin, Hatice; Duran, Gulten; Orman, Mehmet N.; Kocabas, Umut; Payzin, Serdar; Aydin, Mehmet; Antzelevitch, Charles; 35936048; GXG-7709-2022Background: The coexistence of clinical atrioventricular nodal reentrant tachycardia (AVNRT) and drug-induced type 1 Brugada pattern (DI-Type 1 BrP) has been previously reported. The present study was designed to determine the 12-lead ECG characteristics at baseline and during AVNRT and to identify a subset of 12-lead ECG variables of benefit associated with underlying Brugada syndrome (BrS)/DI-Type 1 BrP among patients with slow/fast AVNRT. Methods: A total of 40 (11 numerical/29 categorical) 12-lead ECG parameters were analyzed and compared between patients with (n = 69) and without (n = 104) BrS/DI-Type1-BrP matched for age, female gender, body mass index, left ventricular ejection fraction and comorbid conditions. Five distinct types of ECG pattern (Type A/B/C/D/E) in V1-V2 leads during AVNRT were defined. Results: A total of nine electrocardiographic variables, four at baseline, and five during AVNRT were identified. At baseline, patients with BrS/DI-Type 1 BrP had higher prevalence of interatrial block, leftward shift of frontal plane QRS axis, the absence of normal QRS pattern (the presence of rSr' pattern or type 2/3 Brugada pattern) in V1-V2 and QRS fragmentation in inferior leads compared to patients without BrS/DI-Type 1 BrP. During AVNRT, patients with BrS/DI-Type 1 BrP had higher prevalence of Type A ECG pattern ("coved-type" ST-segment elevation) in V1-V2, Type C ECG pattern (pseudo-r' deflection in V-1 and "RBBB-like" pattern in V-2), pseudo-r' deflection in V-1, QRS fragmentation in inferior leads and "isolated" QRS fragmentation/notching/slurring in aVL compared to patients without BrS/DI-Type 1 BrP. Conclusions: We identify several electrocardiographic variables that point to an underlying type 1 BrP among patients with slow/fast AVNRT.Item Anaesthetic Management of a Patient with Brugada Syndrome in Total Knee Arthroplasty(2021) Tuncali, Bahattin; Kokten, Gizem; Alun, Cihan; 0000-0002-7898-2943; 33718910; AAJ-7840-2021We report the case of a 52-year-old female diagnosed with Brugada syndrome (BrS) scheduled to undergo right total knee arthroplasty. General anaesthesia was induced and maintained with thiopental intravenous sodium + remifentanil and sevoflurane + remifentanil infusion, respectively. Rocuronium bromide was used as the muscle relaxant. The defibrillator was ready for use with the electrodes on the patient. Sugammadex was used for muscle relaxant antagonization. Postoperative analgesia was provided by intermittent morphine HCL via an epidural catheter, intravenous patient-controlled analgesia (Meperidine), and intravenous tenoxicam. The patient was discharged on the 6th day without any problem. Anaesthetic management of patients with BrS is challenging for anaesthesiologists, because fatal cardiac arrhythmias can be triggered by many drugs commonly used in the perioperative period such as bupivacaine, lidocaine, neostigmine, propofol, succinylcholine, ketamine, and tramadol. In these cases, a detailed preoperative evaluation including family history, avoidance of drugs triggering arrhythmia, taking precautions against arrhythmia, and using the agents that are reported to be safe are essential for patient safety.