New findings in Brugada syndrome therapy described from Wilford Hall Medical Center, Department of Emergency Medicine
2007 SEP 24 -- Investigators publish new data in the report "Incidence of Brugada electrocardiographic pattern and outcomes of these patients after intentional tricyclic antidepressant ingestion. Brugada syndrome is a genetic dysfunction of the myocardial sodium channel that leads to ventricular dysrhythmias. The electrocardiographic (ECG) pattern of Brugada syndrome is occasionally seen after tricyclic antidepressant (TCA) ingestion; however, the outcome and complication risk for these patients is not clear," scientists in the United States report. "The objective of our study was to describe the incidence of Brugada ECG pattern (BEP) and serious complications of these patients in a large case series of intentional TCA ingestions. We also compared the proportion of complications of patients with BEP versus those without BEP. We evaluated 402 TCA ingestions, of which 9 (2.3%) were associated with the development of BEP. We compared the adverse outcomes of all TCA ingestions versus TCA ingestions with BEP. A increase in the adverse outcomes in the BEP group was found: seizures (relative risk [RR] 4; 95% confidence interval [CI] 1.5 to 10.8), widened QRS (RR 4.8; 95% CI 1.8 to 12.9), and hypotension (RR 3.9; 95% CI 2.1 to 7.4). To reduce confounding ingestants, we also compared all patients with an isolated TCA ingestion versus those with BEP. A significant increase in adverse outcomes was again found with the BEP group: seizures (RR 3; 95% CI 1.1 to 8.6), widened QRS (RR 4.8; 95% CI 1.5 to 15.1), and hypotension (RR 3.4; 95% CI 1.9 to 22.3). No deaths or dysrhythmias were found in the BEP group," wrote V.S. Bebarta and colleagues, Wilford Hall Medical Center, Department of Emergency Medicine. The researchers concluded: "BEP after TCA ingestion is rare, and death or dysrhythmias did not occur. However, patients with BEP are likely at increased risk for TCA-induced complications." Bebarta and colleagues published their study in American Journal of Cardiology (Incidence of Brugada electrocardiographic pattern and outcomes of these patients after intentional tricyclic antidepressant ingestion. American Journal of Cardiology, 2007;100(4):656-60). For additional information, contact V.S. Bebarta, Wilford Hall Medical Center, Dept. of Emergency Medicine, Division of Medical Toxicology, San Antonio, Texas USA.. The publisher's contact information for the American Journal of Cardiology is: Excerpta Medica Inc., 650 Avenue of the Americas, New York, NY 10011, USA. Keywords: United States, San Antonio, Brugada Syndrome Therapy, Antidepressant, Brugada Syndrome, Cardiology, Therapy, Treatment. This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2007, Biotech Business Week via NewsRx.com.
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