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Autonomic dysfunction caused by spinal cord injury is associated with abnormalities in blood pressure, heart rate variability, arrhythmias and blunted cardiovascular response to exercise which can limit the capacity to perform physical activity [1]. Am J Phys Med Rehabil. 2007 Feb;86(2):142-52. doi: 10.1097/PHM.0b013e31802f0247. 2023.12.010.
Pulsed Field Ablation is a relatively new modality for treatment of atrialfibrillation. In conventional ablation for atrialfibrillation, either heating of tissue is produced by radiofrequency application or freezing of tissues by cryoablation. That was a new analysis of the ADVENT trial [2]. N Engl J Med. May 18, 2024.
This measurement has been correlated with those made at electrophysiology study and may predict the potential risk of rapid anterograde conduction if the person develops atrialfibrillation. QT prolongation and the occurrence of ventricular arrhythmias with exercise are another important aspect of exercise testing in children.
Angina is another common symptom due the hypertrophy which causes a coronary supply demand mismatch Symptoms of HCM include syncope/near syncope, which could be precipitated by exertion, hypovolemia, rapid standing, Valsalva manoeuvre, diuretics, vasodilators or arrhythmia. Palpitations can be felt if there are arrhythmias.
An interesting fact is that many of the persons experience arrhythmias in Brugada syndrome with fever. So there is some relation between fever and precipitation of arrhythmias in Brugada syndrome. Of course, the commonest sustained arrhythmia in general population is atrialfibrillation.
This is the proposed mechanism of precipitation of arrhythmias in Brugada syndrome during febrile episodes. There is a potential risk for drug challenge in that life threatening ventricular arrhythmias could be precipitated. Atrialfibrillation and Brugada syndrome. This leads to shortening of action potential duration.
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