Spontaneous T Wave Alternans in a Patient with Brugada Syndrome—Responses to Intravenous Administration of Class I Antiarrhythmic Drug, Glucose Tolerance Test, and Atrial Pacing

Abstract

Spontaneous T wave alternans in Brugada syndrome. A 43-year-old man with an episode of syncope showed ECG patterns of coved-type ST elevation in leads V1-V3 and right bundle branch block pattern. The patient had spontaneous T wave alternans at baseline, and T wave alternans diminished with distinct development of ST elevation after administration of Na+ channel blocker, and during oral glucose load and atrial pacing. Na+ channel mutation may contribute to the genesis of his ECG changes.