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Fever Increases the Risk for Cardiac Arrest in the Brugada Syndrome
- Ahmad S. Amin, MD;
- Paola G. Meregalli, MD;
- Abdennasser Bardai, MD;
- Arthur A.M. Wilde, MD, PhD; and
- Hanno L. Tan, MD, PhD
- From University of Amsterdam, Amsterdam, the Netherlands, 1105 AZ.
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).
Note fever-induced PR and QRS interval prolongation and elevation of the ST segment in leads V1 and V2 with a typical shape (starting with a high take-off point and descending smoothly into a negative T wave).
Objective: To assess the association between fever and cardiac arrest or ECG changes in patients with the Brugada syndrome.
Methods: We retrospectively assessed the prevalence of fever-triggered ventricular tachycardia, ventricular fibrillation, or sudden death in 111 consecutive index patients with the Brugada syndrome at our institution (age, 48 years [SD, 15]; male–female ratio, …
