Q: 44 years old male with known history of Brugada syndrome is admitted to ICU with COVID-19. What should be the first priority?
Answer: Try to keep him afebrile
Patients with Brugada syndrome very quickly develop ventricular arrhythmias when become febrile. This is particularly of high risk in patients with Brugada Type 1 pattern EKG or previous history of syncope.
#cardiology
References:
1. Roterberg G, El-Battrawy I, Veith M, Liebe V, Ansari U, Lang S, Zhou X, Akin I, Borggrefe M. Arrhythmic events in Brugada syndrome patients induced by fever. Ann Noninvasive Electrocardiol. 2020 May;25(3):e12723. doi: 10.1111/anec.12723. Epub 2019 Nov 20. PMID: 31746533; PMCID: PMC7358877.
2. Michowitz Y, et. al. Fever-related arrhythmic events in the multicenter Survey on Arrhythmic Events in Brugada Syndrome. Heart Rhythm. 2018 Sep;15(9):1394-1401. doi: 10.1016/j.hrthm.2018.04.007. Epub 2018 Apr 9. PMID: 29649615.
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