Isoprenaline and quinidine to calm Brugada VF storm

Abstract

A 3-year-old man with an implanted cardioverter-defibrillator (ICD) for type 2 Brugada syndrome was admitted to coronary care unit with ventricular fibrillation electrical storm and consequent appropriate recurrent ICD shocks. The rhythm did not settle with conventional antiarrhythmics such as β-blockers and amiodarone. An isoprenaline infusion was set up with immediate stabilisation of rhythm. After a period of monitoring, the infusion was stopped and oral quinidine was started. He has remained free of problems for 1 year. This case-report summarises these novel treatments for electrical storm in Brugada syndrome and the mechanism behind them.