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European Heart Journal Advance Access published online on June 7, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl060
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received January 16, 2006
Revised April 26, 2006
Accepted May 12, 2006

Clinical research

Low-dose isoproterenol for repetitive ventricular arrhythmia in patients with Brugada syndrome

Atsuyuki Watanabe 1 *, Kengo Fukushima Kusano 1, Hiroshi Morita 1, Daiji Miura 1, Wakako Sumida 1, Shigeki Hiramatsu 1, Kimikazu Banba 1, Nobuhiro Nishii 1, Satoshi Nagase 1, Kazufumi Nakamura 1, Satoru Sakuragi 1, and Tohru Ohe 1

1 Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Okayama 700-8558, Japan

* To whom correspondence should be addressed.
Atsuyuki Watanabe, E-mail: wata2034{at}mx31.tiki.ne.jp


  Abstract

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 µg), followed by continuous infusion (0.15 µg/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.

Keywords: Isoproterenol; Brugada syndrome; Ventricular arrhythmia.
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