Fever Increases the Risk for Cardiac Arrest in the Brugada Syndrome
Authors: Ahmad S. Amin, Paola G. Meregalli, Abdennasser Bardai, Arthur A.M. Wilde, Hanno L. Tan
Journal: Annals of Internal Medicine (2008)

Letters5 August 2008Fever Increases the Risk for Cardiac Arrest in the Brugada SyndromeAhmad S. Amin, MD, Paola G. Meregalli, MD, Abdennasser Bardai, MD, Arthur A.M. Wilde, MD, PhD, and Hanno L. Tan, MD, PhDAhmad S. Amin, MDFrom University of Amsterdam, Amsterdam, the Netherlands, 1105 AZ., Paola G. Meregalli, MDFrom University of Amsterdam, Amsterdam, the Netherlands, 1105 AZ., Abdennasser Bardai, MDFrom University of Amsterdam, Amsterdam, the Netherlands, 1105 AZ., Arthur A.M. Wilde, MD, PhDFrom University of Amsterdam, Amsterdam, the Netherlands, 1105 AZ., and Hanno L. Tan, MD, PhDFrom University of Amsterdam, Amsterdam, the Netherlands, 1105 AZ.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-3-200808050-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: The Brugada syndrome is a familial arrhythmia that manifests as ventricular tachycardia or ventricular fibrillation. It leads to syncope or sudden death in young adults with structurally normal hearts. Episodes are preceded by ST-segment elevation in precordial leads V1 and V2. An estimated 18% to 30% of patients carry loss-of-function mutations in SCN5A, the gene that encodes the cardiac sodium channel (1). Anecdotes suggest that fever may be associated with cardiac arrest and preceding electrocardiographic (ECG) changes (Figure) (2, 3).Figure.Typical fever-induced electrocardiographic changes in a patient with the Brugada syndrome.Note fever-induced PR and QRS interval prolongation and elevation ...References1. Antzelevitch C, Brugada P, Borggrefe M, Brugada J, Brugada R, Corrado D, et al. Brugada syndrome: report of the second consensus conference. Heart Rhythm. 2005;2:429-40. [PMID: 15898165] CrossrefMedlineGoogle Scholar2. Kalra S, Iskandar SB, Duggal S, Smalligan RD. Fever-induced ST-segment elevation with a Brugada syndrome type electrocardiogram [Letter]. Ann Intern Med. 2008;148:82-4. [PMID: 18166764] LinkGoogle Scholar3. Tan HL, Meregalli PG. Lethal ECG changes hidden by therapeutic hypothermia. Lancet. 2007;369:78. [PMID: 17208645] CrossrefMedlineGoogle Scholar4. Dumaine R, Towbin JA, Brugada P, Vatta M, Nesterenko DV, Nesterenko VV, et al. Ionic mechanisms responsible for the electrocardiographic phenotype of the Brugada syndrome are temperature dependent. Circ Res. 1999;85:803-9. [PMID: 10532948] CrossrefMedlineGoogle Scholar5. Escayg A, MacDonald BT, Meisler MH, Baulac S, Huberfeld G, An-Gourfinkel I, et al. Mutations of SCN1A, encoding a neuronal sodium channel, in two families with GEFS+2. Nat Genet. 2000;24:343-5. [PMID: 10742094] CrossrefMedlineGoogle Scholar6. Novella SP, Hisama FM, Dib-Hajj SD, Waxman SG. A case of inherited erythromelalgia. Nat Clin Pract Neurol. 2007;3:229-34. [PMID: 17410110] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Amsterdam, Amsterdam, the Netherlands, 1105 AZ.Acknowledgment: The authors thank Jan M. Ruijter, PhD (Heart Failure Research Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands) for providing statistical advice.Grant Support: Dr. Tan was supported by the Royal Netherlands Academy of Arts and Sciences and the Netherlands Organisation for Scientific Research (NWO, ZonMW-VICI 918.86.616). Dr. Wilde was supported by the Netherlands Heart Foundation (NHS 2003T302). The funding sources had no role in the study.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFever-Induced ST-Segment Elevation with a Brugada Syndrome–Type Electrocardiogram Sumit Kalra , Said B. Iskandar , Sonia Duggal , and Roger D. 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temperature-sensitive cardiac conduction failurehiPSC-derived cardiomyocytes from Brugada Syndrome patients without identified mutations do not exhibit clear cellular electrophysiological abnormalitiesJ-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledgeJ-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledgeJ-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledgePrognostic significance of fever-induced Brugada syndromeDoes Fever Make Difference?Clinical Features of Genetic Cardiac Diseases Related to Potassium ChannelopathiesImpact of clinical and genetic findings on the management of young patients with Brugada syndromeRisk Stratification in Brugada SyndromeFever-Induced Brugada Syndrome Is More Common Than Previously Suspected: A Cross-Sectional Study from an Endemic AreaAcute Management of Arrhythmias in Patients with ChannelopathiesPrognostic Value of Early Repolarization Pattern in Development of VT/VF in Ischemic Heart Disease, Hypothermia, Etc.Therapy for J Wave SyndromesPrevalence and Clinical Characteristics of Brugada SyndromeRisk Stratification in Brugada Syndrome: Clinical Characteristics, Electrocardiographic Parameters and Auxiliary TestingBrugada syndromeThe multi-faceted aspects of the complex cardiac Nav1.5 protein in membrane function and pathophysiologyInherited ion channel diseases: a brief reviewDas Brugada-EKGRecurrent idiopathic ventricular fibrillation induced by high feverPadrão de Brugada tipo 1 induzido pela febreFever-induced type 1 Brugada patternFever-Induced Brugada SyndromeGenetically engineered SCN5A mutant pig hearts exhibit conduction defects and arrhythmiasPrevalence of Type 1 Brugada Electrocardiographic Pattern Evaluated by Twelve-Lead Twenty-Four-Hour Holter MonitoringUnveiling Specific Triggers and Precipitating Factors for Fatal Cardiac Events in Inherited Arrhythmia SyndromesSíncope em contexto febril – caso clínico de síndrome de BrugadaSyncope in a febrile state: A case report of Brugada syndromeElectrocardiographic Characteristics of Ventricular Arrhythmia in Inherited ChannelopathiesCardiac sodium channels and inherited electrophysiological disorders: an update on the pharmacotherapySyncope and polymorphic ventricular tachycardia in the setting of a febrile illnessFever-induced Brugada pattern: How common is it and what does it mean?Fever and the electrocardiogram: What about Brugada syndrome?Brugada ECG disclosed by acute malaria: is it all about fever and propofol?ST-Segment Elevation and Sudden Death in the AthleteBrugada Syndrome: Clinical and Genetic AspectsInterictal Electrocardiographic and Echocardiographic Changes in Patients With Generalized Tonic-Clonic SeizuresThe diagnostic and therapeutic aspects of loss-of-function cardiac sodium channelopathies in childrenBrugada Phenocopy: New Terminology and Proposed ClassificationA Clinical Approach to Inherited ArrhythmiasVentricular flutter triggered by fever in a patient with Brugada syndromeGenetic and clinical aspects of Brugada syndromeInherited Cardiac Arrhythmia Syndromes: Role of the Sodium ChannelProspective Evaluation of the Familial Prevalence of the Brugada SyndromeThe pathophysiological mechanism underlying Brugada syndromeREVIEW: Sodium Channel (Dys)Function and Cardiac ArrhythmiasCardiac sodium channelopathiesActive Cascade Screening in Primary Inherited Arrhythmia SyndromesThe Brugada ECG PatternFever-triggered ventricular arrhythmias in Brugada syndrome and type 2 long-QT syndromeInherited Cardiac Diseases Caused by Mutations in the Nav1.5 Sodium ChannelDefining new risk factors for out-of-hospital cardiac arrest: A hot opportunity for discovery*Exercise-Induced ECG Changes in Brugada SyndromeA novel SCN5A mutation V1340I in Brugada syndrome augmenting arrhythmias during febrile illnessDrugs and Brugada syndrome patients: Review of the literature, recommendations, and an up-to-date website (www.brugadadrugs.org)Sudden unexpected death in epilepsy: risk factors and potential pathomechanisms12-Kanal-EKG bei Brugada-SyndromSlow and Discontinuous Conduction Conspire in Brugada Syndrome 5 August 2008Volume 149, Issue 3Page: 216-218KeywordsFeversHeartIschemiaMutationSodium channelsSyncopeTemperatureUpper respiratory tract infections ePublished: 5 August 2008 Issue Published: 5 August 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. 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