Introduccion: La medicion del intervalo QTc es una herramienta indispensable para diagnosticar y ... more Introduccion: La medicion del intervalo QTc es una herramienta indispensable para diagnosticar y estratificar el riesgo de eventos cardiacos adversos en los pacientes (p) con los sindromes de QT largo (SQTL) hereditarios. Los intervalos QTc pueden variar en forma ostensible y prolongarse de manera intermitente solo antes, durante o despues de un evento arritmico. Objetivos: Determinar si, en los pacientes con SQTL, existen variaciones significativas de los intervalos QTc cuando se los mide en varias oportunidades. Material y metodos: Se midieron la duracion de los intervalos QTc en tres ECG registrados cada 7 dias, en 25 pacientes con SQTL y 15 controles sanos. Resultados: Los intervalos QTc variaron de manera significativa en ambos grupos. Los valores minimos y maximos de QTc fueron de 492 mseg (rango intercuartil [RIC] 25-75: 463,5-501,5) y 522 mseg (RIC: 503,5-543) en pacientes con SQTL (p < 0,0001), respectivamente. En los individuos sanos, dichos valores fueron de 409 mseg(R...
Tabla 1. La duración del intervalo QTc (seg) por edad y sexo Ambos sexos > 12 años 1-12 años Homb... more Tabla 1. La duración del intervalo QTc (seg) por edad y sexo Ambos sexos > 12 años 1-12 años Hombre Mujer Normal ³ 0,39 < 0,45 ³ 0,39 < 0,45 ³ 0,39 < 0,46 Prolongado ³ 0,45 ³ 0,45 ³ 0,46
Introducción: En estudios previos, se determinó para una población con agravamiento de la diabete... more Introducción: En estudios previos, se determinó para una población con agravamiento de la diabetes tipo 2 con obesidad (DBT+Ob) que sufría estrés una prevalencia del polimorfismo de nucleótido único (SNP) rs4704963 (T > C) del gen Early B-Cell Factor 1 (EBF1) del 16,5%. Objetivos: Determinar la prevalencia de este SNP en pacientes con DBT+ Ob que acuden al Hospital Ramos Mejía de la Ciudad Autónoma de Buenos .Aires y establecer si dicho polimorfismo se asocia con el estrés o la ocurrencia de eventos coronarios agudos. Material y métodos: Se llevó a cabo un estudio observacional, prospectivo, sobre prevalencia del polimorfismo en 53 pacientes con DBT+Ob e índice de masa corporal (IMC) entre 28 y 41, atendidos en el citado hospital en un período de 15 meses. A cada paciente se le computó una escala de estrés percibido, además de evaluarlo mediante la escala de acontecimientos vitales estresantes. Para el análisis estadístico, se realizaron las pruebas de Chi cuadrado y se calcularon los odds ratio (OR). Resultados: La población evaluada (53 pacientes) tuvo una media de edad de 60,2 ±9,77 años; 47,2% fueron hombres. De ellos, 8 individuos (15,1%) presentaron el SNP y todos fueron heterocigotas. Quince sujetos (28,3%) tuvieron síndrome isquémico agudo (SIA) y de estos solo uno (6,6%) tenía el SNP. No se halló relación estadísticamente significativa entre la presencia del SNP y la aparición de SIA (p = 0,282). Catorce pacientes (26,4%) presentaron estrés crónico moderado o grave, y no hubo relación entre este hallazgo y la presencia del SNP (p = 0,979). Conclusiones: La prevalencia del SNP rs4704963 (T > C) del gen EBF1 en la población de DBT+Ob estudiada fue del 15,1% y no se halló relación estadísticamente significativa del SNP con el estrés ni con el SIA.
The relationship between unstable angor (angina) and circadian periodicity of heart rate variabil... more The relationship between unstable angor (angina) and circadian periodicity of heart rate variability (HRV) was explored in a group of patients hospitalized in a coronary care unit (CCU). Patients were classified as normal (whose symptoms had non-cardiovascular origin, n=8), moderate angor (n=13) and severe angor (n=11). A fourth group of ambulatory healthy volunteers (n=12) was included. Individual 24 h Holter
Fil: Principato, Mario Bruno. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos &... more Fil: Principato, Mario Bruno. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Ramos Mejia". Servicio de Cardiologia; Argentina
High-altitude environments are characterized by decreased atmospheric pressures at which individu... more High-altitude environments are characterized by decreased atmospheric pressures at which individuals exhibit a reduced volume of maximal oxygen uptake and arterial partial pressure of oxygen, both of which lead to hypobaric hypoxia. While acute exposure may temporarily offset cardiovascular homeostasis in sea-level residents, native highlanders have become accustomed to these high-altitude conditions and often exhibit variations in normal ECG parameters. As part of the "Altitude Non-differentiated ECG Study" (ANDES) project, this paper aims to systematically review the available literature regarding ECG changes in healthy highlander populations. After searching the PubMed, Medline, and Embase databases, 286 abstracts were screened, of which 13 full-texts were ultimately included. This process was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Major ECG deviations in native healthy highlanders include right QRS axis deviation, right ventricular hypertrophy signs, and more prevalent T-wave inversion in the right precordial leads. Notably, they exhibit a prolonged QTc compared to sea-level residents, although within normal limits. Evidence about increased P-wave amplitude or duration, variations in PR interval, or greater prevalence of complete right bundle branch block is not conclusive. This review provides ECG reference standards that can be used by clinicians, who should be aware of the effects of high-altitude residence on cardiovascular health and how these may change according to age, ethnicity, and other factors.
Journal of Innovations in Cardiac Rhythm Management, 2015
Andersen-Tawil syndrome is an autosomal dominant, multisystem disorder characterized by periodic ... more Andersen-Tawil syndrome is an autosomal dominant, multisystem disorder characterized by periodic paralysis, dysmorphic features and cardiac arrhythmias. Mutations in the KCNJ2 gene, which encodes potassium channels, have been identified in individuals with Andersen-Tawil syndrome. These individuals can present with typical electrocardiographic findings that can prognosticate their tendency to develop lethal arrhythmias. However, literature on cardiac and clinical findings in this population is scarce. We analyzed the clinical characteristics, electrocardiographic patterns and the risk of potentially malignant cardiac arrhythmias in seven subjects with Andersen-Tawil syndrome. All patients reported episodes of palpitations. Forty-two percent had syncope or presyncope and 28% had a history of periodic paralysis. A family history of sudden death was present in 42.8%. Electrocardiogram analysis showed prominent U-waves in 57%. The mean QTc and QUc intervals were 432.7±23.23 ms and 599.1±83.82 ms, respectively. Exercise stress testing induced ventricular arrhythmias in all patients in the initial stages. The 24-h Holter monitoring showed frequent ventricular premature beats (85%) and episodes of nonsustained polymorphic or bidirectional ventricular tachycardia (71%). Patients with Andersen-Tawil syndrome have a significant clinical burden of ventricular arrhythmias that can progress to sudden cardiac death. The 24-h Holter monitoring and exercise stress test were highly efficient methods to detect the presence of potentially lethal ventricular arrhythmias and should be used in the diagnostic work-up of patients with Andersen-Tawil syndrome.
SUMMARY Giant negative T waves or massive T wave inversion are defined by the presence of negativ... more SUMMARY Giant negative T waves or massive T wave inversion are defined by the presence of negative T waves with an amplitude≥ 1 mV in at least two consecutive electrocardiographic leads. A 66 year-old asymptomatic woman who underwent a routine ...
Revista Española de Cardiología (English Edition), 2004
We present a 56-year-old man who was admitted to an emergency service after receiving an electric... more We present a 56-year-old man who was admitted to an emergency service after receiving an electric shock. The ECG showed a J point and ST segment elevation of up to 5 mm in leads V1 to V3, which normalized in 24 hours. The ajmaline test caused elevation of the J point and of the ST segment up to 12 mm in leads V1 to V3, QTc lengthening, and QTc and T wave alternans. These results denoted alterations in the duration of myocardial action potentials, a common finding in patients with Brugada syndrome and long QT syndrome.
Director Dr. Claudio Militello MTSAC Committee of Editorial Staff Dr. Rafael Acunzo MTSAC Dr. Gas... more Director Dr. Claudio Militello MTSAC Committee of Editorial Staff Dr. Rafael Acunzo MTSAC Dr. Gastón Albina MTSAC Dr. Darío Di Toro MTSAC Dra. Ana Tambussi Dra. Aurora Ruiz Collaborators Dra. Claudia Bucay, Dr. César Cáceres Monié Dra. Milagros Caro Dr. Diego Conde Dr. José Estepo MTSAC Dr. Alejandro Franco MTSAC Dr. Luciano Faivelis Dr. Enrique Gayet Dr. Javier Guetta Dr. Juan Cruz López Diez Dr. Mario Principato Dr. Horacio Quiroga Ponce Committe of Review Dr. Mauricio Abello MTSAC Dr. Rodolfo Ahuad Guerrero MTSAC Dr. Luis Barja MTSAC Dr. Carlos Barrero MTSAC Dr. César Belziti MTSAC Dr. Andrés Bochoeyer MTSAC Dr. Sergio Dubner MTSAC Dr. Marcelo Elizari MTSAC Dr. Néstor Galizio MTSAC Dr. Alberto Giniger MTSAC Dr. Hugo Grancelli MTSAC Dr. José Luis González MTSAC Dr. Carlos Labadet MTSAC Dr. Jorge Lerman MTSAC Dr. José Moltedo MTSAC Dr. Daniel Ortega MTSAC Dr. Oscar Oseroff MTSAC Dr. Rafael Porcile MTSAC Dr. Rafael Rabinovich MTSAC Dr. Enrique Retyk MTSAC Dr. Claudio Zuloaga MTSAC A...
Resumen es: Se define onda T negativa gigante o inversion masiva de la onda T a la aparicion de o... more Resumen es: Se define onda T negativa gigante o inversion masiva de la onda T a la aparicion de ondas T negativas con una amplitud ≥ 1 mV en por lo menos dos derivac...
Background The congenital long QT syndrome type 2 is caused by mutations in KCNH2 gene that encod... more Background The congenital long QT syndrome type 2 is caused by mutations in KCNH2 gene that encodes the alpha subunit of potassium channel Kv11.1. The carriers of the pathogenic variant of KCNH2 gene manifest a phenotype characterized by prolongation of QT interval and increased risk of sudden cardiac death due to life-threatening ventricular tachyarrhythmias. Results A family composed of 17 members with a family history of sudden death and recurrent syncopes was studied. The DNA of proband with clinical manifestations of long QT syndrome was analyzed using a massive DNA sequencer that included the following genes: KCNQ1, KCNH2, SCN5A, KCNE1, KCNE2, ANK2, KCNJ2, CACNA1, CAV3, SCN1B, SCN4B, AKAP9, SNTA1, CALM1, KCNJ5, RYR2 and TRDN. DNA sequencing of proband identified a novel pathogenic variant of KCNH2 gene produced by a heterozygous frameshift mutation c.46delG, pAsp16Thrfs*44 resulting in the synthesis of a truncated alpha subunit of the Kv11.1 ion channel. Eight family members m...
Journal of Interventional Cardiac Electrophysiology
COVID-19 infection has shown rapid growth worldwide, and different therapies have been proposed f... more COVID-19 infection has shown rapid growth worldwide, and different therapies have been proposed for treatment, in particular, the combination of immune response modulating drugs such as chloroquine and hydroxychloroquine (antimalarials) alone or in combination with azithromycin. Although the clinical evidence supporting their use is scarce, the off label use of these drugs has spread very quickly in face of the progression of the epidemic and the high mortality rate in susceptible populations. However, these medications can pathologically prolong the QT interval and lead to malignant ventricular arrhythmias such that organized guidance on QT evaluation and management strategies are important to reduce morbidity associated with the potential large-scale use.
Inverted connection of the atrial and ventricular leads is an unusual circumstance during the imp... more Inverted connection of the atrial and ventricular leads is an unusual circumstance during the implantation of a dual-chamber pacemaker. Yet, PMT may present in the absence of complex mechanisms. The detection and termination algorithms used by the device proved to be efficient for the adequate diagnosis and treatment.
We describe the induction of a masquerading bundle branch block in two patients with Brugada synd... more We describe the induction of a masquerading bundle branch block in two patients with Brugada syndrome following the administration of Ajmaline. The development of this conduction disturbance prevented the correct electrocardiographic diagnosis. However, the simultaneously obtained vectocardiogram identified both the Brugada pattern and the masquerading bundle branch block.
Introduccion: La medicion del intervalo QTc es una herramienta indispensable para diagnosticar y ... more Introduccion: La medicion del intervalo QTc es una herramienta indispensable para diagnosticar y estratificar el riesgo de eventos cardiacos adversos en los pacientes (p) con los sindromes de QT largo (SQTL) hereditarios. Los intervalos QTc pueden variar en forma ostensible y prolongarse de manera intermitente solo antes, durante o despues de un evento arritmico. Objetivos: Determinar si, en los pacientes con SQTL, existen variaciones significativas de los intervalos QTc cuando se los mide en varias oportunidades. Material y metodos: Se midieron la duracion de los intervalos QTc en tres ECG registrados cada 7 dias, en 25 pacientes con SQTL y 15 controles sanos. Resultados: Los intervalos QTc variaron de manera significativa en ambos grupos. Los valores minimos y maximos de QTc fueron de 492 mseg (rango intercuartil [RIC] 25-75: 463,5-501,5) y 522 mseg (RIC: 503,5-543) en pacientes con SQTL (p < 0,0001), respectivamente. En los individuos sanos, dichos valores fueron de 409 mseg(R...
Tabla 1. La duración del intervalo QTc (seg) por edad y sexo Ambos sexos > 12 años 1-12 años Homb... more Tabla 1. La duración del intervalo QTc (seg) por edad y sexo Ambos sexos > 12 años 1-12 años Hombre Mujer Normal ³ 0,39 < 0,45 ³ 0,39 < 0,45 ³ 0,39 < 0,46 Prolongado ³ 0,45 ³ 0,45 ³ 0,46
Introducción: En estudios previos, se determinó para una población con agravamiento de la diabete... more Introducción: En estudios previos, se determinó para una población con agravamiento de la diabetes tipo 2 con obesidad (DBT+Ob) que sufría estrés una prevalencia del polimorfismo de nucleótido único (SNP) rs4704963 (T > C) del gen Early B-Cell Factor 1 (EBF1) del 16,5%. Objetivos: Determinar la prevalencia de este SNP en pacientes con DBT+ Ob que acuden al Hospital Ramos Mejía de la Ciudad Autónoma de Buenos .Aires y establecer si dicho polimorfismo se asocia con el estrés o la ocurrencia de eventos coronarios agudos. Material y métodos: Se llevó a cabo un estudio observacional, prospectivo, sobre prevalencia del polimorfismo en 53 pacientes con DBT+Ob e índice de masa corporal (IMC) entre 28 y 41, atendidos en el citado hospital en un período de 15 meses. A cada paciente se le computó una escala de estrés percibido, además de evaluarlo mediante la escala de acontecimientos vitales estresantes. Para el análisis estadístico, se realizaron las pruebas de Chi cuadrado y se calcularon los odds ratio (OR). Resultados: La población evaluada (53 pacientes) tuvo una media de edad de 60,2 ±9,77 años; 47,2% fueron hombres. De ellos, 8 individuos (15,1%) presentaron el SNP y todos fueron heterocigotas. Quince sujetos (28,3%) tuvieron síndrome isquémico agudo (SIA) y de estos solo uno (6,6%) tenía el SNP. No se halló relación estadísticamente significativa entre la presencia del SNP y la aparición de SIA (p = 0,282). Catorce pacientes (26,4%) presentaron estrés crónico moderado o grave, y no hubo relación entre este hallazgo y la presencia del SNP (p = 0,979). Conclusiones: La prevalencia del SNP rs4704963 (T > C) del gen EBF1 en la población de DBT+Ob estudiada fue del 15,1% y no se halló relación estadísticamente significativa del SNP con el estrés ni con el SIA.
The relationship between unstable angor (angina) and circadian periodicity of heart rate variabil... more The relationship between unstable angor (angina) and circadian periodicity of heart rate variability (HRV) was explored in a group of patients hospitalized in a coronary care unit (CCU). Patients were classified as normal (whose symptoms had non-cardiovascular origin, n=8), moderate angor (n=13) and severe angor (n=11). A fourth group of ambulatory healthy volunteers (n=12) was included. Individual 24 h Holter
Fil: Principato, Mario Bruno. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos &... more Fil: Principato, Mario Bruno. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Ramos Mejia". Servicio de Cardiologia; Argentina
High-altitude environments are characterized by decreased atmospheric pressures at which individu... more High-altitude environments are characterized by decreased atmospheric pressures at which individuals exhibit a reduced volume of maximal oxygen uptake and arterial partial pressure of oxygen, both of which lead to hypobaric hypoxia. While acute exposure may temporarily offset cardiovascular homeostasis in sea-level residents, native highlanders have become accustomed to these high-altitude conditions and often exhibit variations in normal ECG parameters. As part of the "Altitude Non-differentiated ECG Study" (ANDES) project, this paper aims to systematically review the available literature regarding ECG changes in healthy highlander populations. After searching the PubMed, Medline, and Embase databases, 286 abstracts were screened, of which 13 full-texts were ultimately included. This process was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Major ECG deviations in native healthy highlanders include right QRS axis deviation, right ventricular hypertrophy signs, and more prevalent T-wave inversion in the right precordial leads. Notably, they exhibit a prolonged QTc compared to sea-level residents, although within normal limits. Evidence about increased P-wave amplitude or duration, variations in PR interval, or greater prevalence of complete right bundle branch block is not conclusive. This review provides ECG reference standards that can be used by clinicians, who should be aware of the effects of high-altitude residence on cardiovascular health and how these may change according to age, ethnicity, and other factors.
Journal of Innovations in Cardiac Rhythm Management, 2015
Andersen-Tawil syndrome is an autosomal dominant, multisystem disorder characterized by periodic ... more Andersen-Tawil syndrome is an autosomal dominant, multisystem disorder characterized by periodic paralysis, dysmorphic features and cardiac arrhythmias. Mutations in the KCNJ2 gene, which encodes potassium channels, have been identified in individuals with Andersen-Tawil syndrome. These individuals can present with typical electrocardiographic findings that can prognosticate their tendency to develop lethal arrhythmias. However, literature on cardiac and clinical findings in this population is scarce. We analyzed the clinical characteristics, electrocardiographic patterns and the risk of potentially malignant cardiac arrhythmias in seven subjects with Andersen-Tawil syndrome. All patients reported episodes of palpitations. Forty-two percent had syncope or presyncope and 28% had a history of periodic paralysis. A family history of sudden death was present in 42.8%. Electrocardiogram analysis showed prominent U-waves in 57%. The mean QTc and QUc intervals were 432.7±23.23 ms and 599.1±83.82 ms, respectively. Exercise stress testing induced ventricular arrhythmias in all patients in the initial stages. The 24-h Holter monitoring showed frequent ventricular premature beats (85%) and episodes of nonsustained polymorphic or bidirectional ventricular tachycardia (71%). Patients with Andersen-Tawil syndrome have a significant clinical burden of ventricular arrhythmias that can progress to sudden cardiac death. The 24-h Holter monitoring and exercise stress test were highly efficient methods to detect the presence of potentially lethal ventricular arrhythmias and should be used in the diagnostic work-up of patients with Andersen-Tawil syndrome.
SUMMARY Giant negative T waves or massive T wave inversion are defined by the presence of negativ... more SUMMARY Giant negative T waves or massive T wave inversion are defined by the presence of negative T waves with an amplitude≥ 1 mV in at least two consecutive electrocardiographic leads. A 66 year-old asymptomatic woman who underwent a routine ...
Revista Española de Cardiología (English Edition), 2004
We present a 56-year-old man who was admitted to an emergency service after receiving an electric... more We present a 56-year-old man who was admitted to an emergency service after receiving an electric shock. The ECG showed a J point and ST segment elevation of up to 5 mm in leads V1 to V3, which normalized in 24 hours. The ajmaline test caused elevation of the J point and of the ST segment up to 12 mm in leads V1 to V3, QTc lengthening, and QTc and T wave alternans. These results denoted alterations in the duration of myocardial action potentials, a common finding in patients with Brugada syndrome and long QT syndrome.
Director Dr. Claudio Militello MTSAC Committee of Editorial Staff Dr. Rafael Acunzo MTSAC Dr. Gas... more Director Dr. Claudio Militello MTSAC Committee of Editorial Staff Dr. Rafael Acunzo MTSAC Dr. Gastón Albina MTSAC Dr. Darío Di Toro MTSAC Dra. Ana Tambussi Dra. Aurora Ruiz Collaborators Dra. Claudia Bucay, Dr. César Cáceres Monié Dra. Milagros Caro Dr. Diego Conde Dr. José Estepo MTSAC Dr. Alejandro Franco MTSAC Dr. Luciano Faivelis Dr. Enrique Gayet Dr. Javier Guetta Dr. Juan Cruz López Diez Dr. Mario Principato Dr. Horacio Quiroga Ponce Committe of Review Dr. Mauricio Abello MTSAC Dr. Rodolfo Ahuad Guerrero MTSAC Dr. Luis Barja MTSAC Dr. Carlos Barrero MTSAC Dr. César Belziti MTSAC Dr. Andrés Bochoeyer MTSAC Dr. Sergio Dubner MTSAC Dr. Marcelo Elizari MTSAC Dr. Néstor Galizio MTSAC Dr. Alberto Giniger MTSAC Dr. Hugo Grancelli MTSAC Dr. José Luis González MTSAC Dr. Carlos Labadet MTSAC Dr. Jorge Lerman MTSAC Dr. José Moltedo MTSAC Dr. Daniel Ortega MTSAC Dr. Oscar Oseroff MTSAC Dr. Rafael Porcile MTSAC Dr. Rafael Rabinovich MTSAC Dr. Enrique Retyk MTSAC Dr. Claudio Zuloaga MTSAC A...
Resumen es: Se define onda T negativa gigante o inversion masiva de la onda T a la aparicion de o... more Resumen es: Se define onda T negativa gigante o inversion masiva de la onda T a la aparicion de ondas T negativas con una amplitud ≥ 1 mV en por lo menos dos derivac...
Background The congenital long QT syndrome type 2 is caused by mutations in KCNH2 gene that encod... more Background The congenital long QT syndrome type 2 is caused by mutations in KCNH2 gene that encodes the alpha subunit of potassium channel Kv11.1. The carriers of the pathogenic variant of KCNH2 gene manifest a phenotype characterized by prolongation of QT interval and increased risk of sudden cardiac death due to life-threatening ventricular tachyarrhythmias. Results A family composed of 17 members with a family history of sudden death and recurrent syncopes was studied. The DNA of proband with clinical manifestations of long QT syndrome was analyzed using a massive DNA sequencer that included the following genes: KCNQ1, KCNH2, SCN5A, KCNE1, KCNE2, ANK2, KCNJ2, CACNA1, CAV3, SCN1B, SCN4B, AKAP9, SNTA1, CALM1, KCNJ5, RYR2 and TRDN. DNA sequencing of proband identified a novel pathogenic variant of KCNH2 gene produced by a heterozygous frameshift mutation c.46delG, pAsp16Thrfs*44 resulting in the synthesis of a truncated alpha subunit of the Kv11.1 ion channel. Eight family members m...
Journal of Interventional Cardiac Electrophysiology
COVID-19 infection has shown rapid growth worldwide, and different therapies have been proposed f... more COVID-19 infection has shown rapid growth worldwide, and different therapies have been proposed for treatment, in particular, the combination of immune response modulating drugs such as chloroquine and hydroxychloroquine (antimalarials) alone or in combination with azithromycin. Although the clinical evidence supporting their use is scarce, the off label use of these drugs has spread very quickly in face of the progression of the epidemic and the high mortality rate in susceptible populations. However, these medications can pathologically prolong the QT interval and lead to malignant ventricular arrhythmias such that organized guidance on QT evaluation and management strategies are important to reduce morbidity associated with the potential large-scale use.
Inverted connection of the atrial and ventricular leads is an unusual circumstance during the imp... more Inverted connection of the atrial and ventricular leads is an unusual circumstance during the implantation of a dual-chamber pacemaker. Yet, PMT may present in the absence of complex mechanisms. The detection and termination algorithms used by the device proved to be efficient for the adequate diagnosis and treatment.
We describe the induction of a masquerading bundle branch block in two patients with Brugada synd... more We describe the induction of a masquerading bundle branch block in two patients with Brugada syndrome following the administration of Ajmaline. The development of this conduction disturbance prevented the correct electrocardiographic diagnosis. However, the simultaneously obtained vectocardiogram identified both the Brugada pattern and the masquerading bundle branch block.
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