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Pacing Clin Electrophysiol. 2011 Jan;34(1):e1-5. doi: 10.1111/j.1540-8159.2010.02735.x.

Ventricular fibrillation and ventricular tachycardia triggered by late-coupled ventricular extrasystoles in a Brugada syndrome patient.

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Department of Internal Medicine, School of Health Science First, Niigata University School of Medicine, Niigata, Japan.


Premature ventricular complexes (PVC) falling after the end of the T wave triggered ventricular fibrillation (VF) at night and monomorphic ventricular tachycardia (MVT) during daytime, in a recipient of implantable cardioverter defibrillator with Brugada syndrome. Treatment with bepridil (1) decreased the height of ST segment elevation in leads V1-V3, (2) completely eliminated VF, and (3) markedly decreased the incidence of PVC and MVT. Albeit rare, VF can be triggered by late-coupled PVC, due to a mechanism other than phase 2 reentry in some patients with Brugada syndrome.

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