A Phenotypic Combination of Idiopathic VF and Brugada Syndrome

This case study shows a young male presenting a mixture of two disease entities: (1) Brugada syndrome with a nearly-normal baseline electrocardiogram and positive Ajmaline drug challenge as well as (2) idiopathic ventricular fibrillation including extremely short-coupled monomorphic ventricular premature beats (VPB) triggering ventricular fibrillation (coupling interval 318 ± 21 ms). In this phenotypic patient group—more suggestive of idiopathic ventricular fibrillation due to the ultra-short coupling interval of the VPBs—drug treatment with a class IA agent such as Quinidine might be an important option to implantable cardioverter-defibrillator and ablation therapy. (PACE 2010; 33:e84–e87)