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M H Monroe

Publications and source records attributed to M H Monroe.

4 recordsLinked to original sources

Two-year case collection of the Brugada syndrome electrocardiogram pattern at a large teaching hospital.

BACKGROUND: Recommendations have recently emerged suggesting that the presence of the Brugada electrocardiographic (ECG) pattern in an otherwise asymptomatic individual warrants electrophysiologic testing for inducible ventricular arrhythmias. However, the prevalence of this pattern in the general population and its specificity for identifying those likely to develop the true Brugada syndrome are not known. HYPOTHESIS: The purpose of this study was to collect ECGs that displayed the Brugada pattern from unselected, noncardiac patients at a single institution to determine whether the implied prevalence in the literature may represent a significant underestimation of the true prevalence. METHODS: We performed a prospective case collection of Brugada-patterned ECGs over a 2-year time period from unselected, noncardiac patients at a large urban teaching hospital. RESULTS: Of approximately 12,000 noncardiac patients, 52 were found to have an ECG pattern fully consistent with the Brugada sign. CONCLUSIONS: The Brugada type ECG pattern is much more prevalent than previously reported when rigorously searched for in a prospective manner. More data are needed on its specificity for predicting future arrhythmic events in asymptomatic individuals before recommendations are made for extensive evaluation in this group.

Adult↗

Brugada-type electrocardiographic pattern induced by cocaine.

Right bundle branch block with coved ST-segment elevation in leads V1 through V3 is the electrocardiographic (ECG) marker of the Brugada syndrome. We describe a healthy young man with a normal baseline ECG in whom a transient Brugada pattern was observed repeatedly after recreational cocaine use. Intravenous administration of procainamide and subsequent intravenous propranolol followed by noradrenaline failed to reproduce the Brugada sign. An electrophysiologic study performed in the presence of the Brugada ECG pattern showed no inducible arrhythmias. This case illustrates that, in susceptible individuals, cocaine may provoke the Brugada sign. The clinical importance of this cocaine-induced ECG abnormality is currently unknown.

Administration, Inhalation↗