Background Brugada syndrome (BS) is a hereditary channelopathy associated with syncope, malignant ventricular arrhythmia, and sudden cardiac death. Right ventricular ischaemia and BS have similar underlying substrates precipitating ventricular tachycardia or fibrillation (VF). ................................................................................................................................................................................................... Case summary A 72-year-old woman with BS and a stenosis on the proximal right coronary artery received several subsequent implantable cardioverter-defibrillator shocks due to VF during an episode of extreme nausea with vomiting. ................................................................................................................................................................................................... Discussion This case report emphasizes on the synergetic effect of mild ischaemia and increased vagal tone on the substrate responsible for BS to create pathophysiological changes precipitating VF.

Brugada syndrome • Ischaemia • Myocardial infarction • Vagal tone • Ventricular arrhythmia • Shock • Case report
dx.doi.org/10.1093/ehjcr/ytaa202, hdl.handle.net/1765/133901
European Heart Journal - Case Reports
Department of Cardiology

Van Malderen, S.C.H., Schultz, C.J., Jordaens, L.J.L.M, Hunter, R., Khan, H, Simovic, S., & Thomson, R. (2020). Case report: Synergetic effect of ischaemia and increased vagal tone inducing ventricular fibrillation in a patient with Brugada syndrome. European Heart Journal - Case Reports, 4(4). doi:10.1093/ehjcr/ytaa202