Remove 2017 Remove Cardiac Arrest Remove Sudden Cardiac Death
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VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Dr. Smith's ECG Blog

This is a critically important determination because of the 2017 AHA/ACC/HRS Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death. Frick — "Angiography can be misleading — and must always be understood in clinical context".

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A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

This discussion comes from this previous post: Hyperthermia and ST Elevation Discussion Brugada Type 1 ECG changes are associated with sudden cardiac death (SCD) and the occurrence of ventricular dysrhythmias. See more cases of Brugada due to fever here. per year. Heart Rhythm, 15(9): 1394-1401. [7]

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Brugada Syndrome: Diagnosis and Risk Stratification

All About Cardiovascular System and Disorders

Brugada syndrome is thought to account for about one fourth of sudden cardiac deaths in individuals with structurally normal heart. 2017 Mar;110(3):188-195. Even though mutations in other channels have been described in Brugada syndrome, only those in SCN5A gene are considered to be definitely disease causing.

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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

The limb lead abnormalities appear to be part of the Brugada pattern, as described in this article: Inferior and Lateral Electrocardiographic RepolarizationAbnormalities in Brugada Syndrome Discussion Brugada Type 1 ECG changes are associated with sudden cardiac death (SCD) and the occurrence of ventricular dysrhythmias.

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Lowering Atherosclerotic Cardiovascular Disease Events by Treating Residual Inflammatory Risk

DAIC

12,16 In 2017, CANTOS (Canakinumab Anti-inflammatory Thrombosis Outcomes Study) provided proof-of-principle that inflammation inhibition in the absence of lipid lowering can significantly reduce cardiovascular event rates and helped to define the interleukin-1 (IL-1) to IL-6 to CRP pathway as a central target in CV disease.16

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QT Correction Formulas Compared to The Rule of Thumb ("Half the RR")

Dr. Smith's ECG Blog

However, according to these diagnostic criteria (JACC 2011; 57(7):802), it is a Bazett corrected QT of less than 330-370, depending on other diagnostic criteria, including 1) h/o cardiac arrest, 2) sudden syncope, 3) family hx of sudden unexplained arrest at age less than 40, 4) family hx of SQTS.

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A young F is hyperthermic, delirious, and dry: Fever-induced Brugada? Diphenhydramine toxicity? Tricyclic?

Dr. Smith's ECG Blog

Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had sudden cardiac arrest in sleep. This is based on the Sieira et al, 2017, risk calculator , which gives a borderline risk score (2). years and 71.6% (67 of 88) were men. y (3 of 88, 43.6 ± 37.4