Abstract
We report a case of catheter ablation of Brugada syndrome (BrS) in a
patient with refractory ventricular fibrillation (VF) despite quinidine
therapy. We performed epicardial substrate mapping which identified an
area of abnormal fractionated, prolonged electrogram in the anterior
right ventricular outflow tract. Warm saline infusion into the
pericardial space induced further delay of the local electrogram,
consistent with BrS physiology. Coronary angiogram confirmed the area
was distant from major coronary arteries. Ablation was performed in this
area which eliminated local abnormal electrograms and led to the
disappearance of coved-type ST elevation in V1-V2. No VF recurred at
3-month follow-up.