Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-28T16:02:10.079Z Has data issue: false hasContentIssue false
  • English
  • Français

Post-operative Brugada electrocardiographic pattern, polymorphic ventricular tachycardia, and sudden death in a child after administration of propofol anaesthesia

Published online by Cambridge University Press:  27 March 2020

Duygu Uzun ,
Nimra Hassan  and
Utkarsh Kohli Open the ORCID record for Utkarsh Kohli [Opens in a new window]
Duygu Uzun
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, St. John Hospital Medical Center, Detroit, MI, USA
Nimra Hassan
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, St. John Hospital Medical Center, Detroit, MI, USA
Utkarsh Kohli*
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, St. John Hospital Medical Center, Detroit, MI, USA Department of Pediatrics, Division of Pediatric Cardiology, The University of Chicago Pritzker School of Medicine, Chicago, IL, USA
*
Author for correspondence: U. Kohli, MD, Department of Pediatrics, Division of Pediatric Cardiology, The University of Chicago Pritzker School of Medicine, 5721 S Maryland Ave., MC 4051, Chicago, IL60637, USA. Tel: +1 773 702 6172; Fax: 773-702-2319; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

A 9-year-old African-American girl presented with sudden cardiac arrest a few hours after adenotonsillectomy. She received anaesthesia which included propofol during the procedure. Her electrocardiogram (EKG) showed type 1 Brugada pattern, and genetic testing revealed a variant of unknown significance in desmoplakin (DSP) gene. We discuss the association between propofol, Brugada EKG pattern, and malignant ventricular arrhythmias.

Keywords

PropofolBrugada syndromesudden cardiac arrest
Type
Brief Report
Information
Cardiology in the Young , Volume 30 , Issue 5 , May 2020 , pp. 724 - 727
Copyright
© The Author(s) 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brugada, P, Brugada, J. Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report. J Am Coll Cardiol 1992; 20: 1391–1396.CrossRefGoogle ScholarPubMed
Behere, SP, Weindling, SN. Brugada syndrome in children – stepping into uncharted territory. Ann Pediatr Cardiol 2017; 10: 248–258.CrossRefGoogle Scholar
Priori, SG, Wilde, AA, Horie, M, et al. HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes: document endorsed by HRS, EHRA, and APHRS in May 2013 and by ACCF, AHA, PACES, and AEPC in June 2013. Heart Rhythm 2013; 10: 1932–1963.10.1016/j.hrthm.2013.05.014CrossRefGoogle Scholar
Gourraud, JB, Barc, J, Thollet, A, Le Marec, H, Probst, V. Brugada syndrome: diagnosis, risk stratification and management. Arch Cardiovasc Dis 2017; 110: 188–195.CrossRefGoogle ScholarPubMed
Andorin, A, Behr, ER, Denjoy, I, et al. Impact of clinical and genetic findings on the management of young patients with Brugada syndrome. Heart Rhythm 2016; 13: 1274–1282.CrossRefGoogle ScholarPubMed
Junttila, MJ, Gonzalez, M, Lizotte, E, et al. Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. Circulation 2008; 117: 1890–1893.CrossRefGoogle ScholarPubMed
Inamura, M, Okamoto, H, Kuroiwa, M, Hoka, S. General anesthesia for patients with Brugada syndrome. A report of six cases. Can J of Anaesth 2005; 52: 409–412.CrossRefGoogle ScholarPubMed
Vernooy, K, Delhaas, T, Cremer, OL, et al. Electrocardiographic changes predicting sudden death in propofol-related infusion syndrome. Heart Rhythm 2006; 3: 131–137.CrossRefGoogle ScholarPubMed
Riera, AR, Uchida, AH, Schapachnik, E, Dubner, S, Filho, CF, Ferreira, C. Propofol infusion syndrome and Brugada syndrome electrocardiographic phenocopy. Cardiol J 2010; 17: 130–135.Google ScholarPubMed
Weiner, JB, Haddad, EV, Raj, SR. Recovery following propofol-associated brugada electrocardiogram. Pacing Clin Electrophysiol 2010; 33: e39–e42.CrossRefGoogle ScholarPubMed
Jorens, PG, Van den Eynden, GG. Propofol infusion syndrome with arrhythmia, myocardial fat accumulation and cardiac failure. Am J Cardiol 2009; 104: 1160–1162.10.1016/j.amjcard.2009.05.065CrossRefGoogle ScholarPubMed
Fong, JJ, Sylvia, L, Ruthazer, R, Schumaker, G, Kcomt, M, Devlin, JW. Predictors of mortality in patients with suspected propofol infusion syndrome. Crit Care Med 2008; 36: 2281–2287.CrossRefGoogle ScholarPubMed
Wutzler, A, De Asmundis, C, Matsuda, H, et al. Effects of propofol on ventricular repolarization and incidence of malignant arrhythmias in adults. J Electrocardiol 2018; 51: 170–174.CrossRefGoogle ScholarPubMed
Kwon, HM, Kim, SH, Park, SU, et al. Propofol for implantable cardioverter defibrillator implantation in patients with Brugada syndrome. Pacing Clin Electrophysiol 2018; 41: 656–660.CrossRefGoogle ScholarPubMed
Duque, M, Santos, L, Ribeiro, S, Catre, D. Anesthesia and Brugada syndrome: a 12-year case series. J Clin Anesth 2017; 36: 168–173.CrossRefGoogle ScholarPubMed
Flamée, P, De Asmundis, C, Bhutia, JT, et al. Safe single-dose administration of propofol in patients with established Brugada syndrome: a retrospective database analysis. Pacing Clin Electrophysiol 2013; 36: 1516–1521.CrossRefGoogle ScholarPubMed
Kloesel, B, Ackerman, MJ, Sprung, J, Narr, BJ, Weingarten, TN. Anesthetic management of patients with Brugada syndrome: a case series and literature review. Can J Anesth 2011; 58: 824–836.CrossRefGoogle ScholarPubMed
Ciconte, G, Santinelli, V, Brugada, J, et al. General anesthesia attenuates Brugada syndrome phenotype expression: clinical implications from a prospective clinical trial. JACC Clin Electrophysiol 2018; 4: 518–530.CrossRefGoogle ScholarPubMed
Katsanos, AH, Krantzopoulos, P, Tsivgoulis, G, et al. Electrocadiographic abnormalities and cardiac arrhythmias in structural brain lesions. Int J Cardiol 2013; 167: 328–334.CrossRefGoogle Scholar
Otterspoor, LC, Kalkman, CJ, Cremer, OL. Update on the propofol infusion syndrome in ICU management of patients with head injury. Curr Opin Anaesthesiol 2008; 21: 544–551.CrossRefGoogle ScholarPubMed
American Academy of Pediatrics. Section on Anesthesiology. Evaluation and preparation of pediatric patients undergoing anesthesia. Pediatrics 1996; 98: 502–508.Google Scholar
Vetter, VL. Electrocardiographic screening of all infants, children, and teenagers should be performed. Circulation 2014; 130: 688–697.CrossRefGoogle Scholar
Hosseini, SM, Kim, R, Udupa, S, et al. National institutes of health clinical genome resource consortium. Reappraisal of reported genes for sudden arrhythmic death. Circulation 2018; 138: 1195–1205.CrossRefGoogle ScholarPubMed
Zhao, Q, Chen, Y, Peng, L, et al. Identification of rare variants of DSP gene in sudden unexplained nocturnal death syndrome in the southern Chinese Han population. Int J Legal Med 2016; 130: 317–322.CrossRefGoogle ScholarPubMed
Kiselev, A, Mikhaylov, E, Pamon, E, et al. Progressive cardiac conduction disease associated with a DSP gene mutation. Int J Cardiol 2016; 216: 188–189.CrossRefGoogle ScholarPubMed