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CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 2, March 2013
e2
AFRICA
following exposure to sodium channel blockers, is thought to
be associated with an increased risk for the development of
ventricular tachycardia/ventricular fibrillation.
6,7
Little is known
about the occurrence of T-wave alternans in patients with
Brugada syndrome.
An experimental model of Brugada syndrome showed
that T-wave alternans may be due to alternating loss of the
epicardial action potential dome and/or concealed phase 2
re-entry, both serving to increase transmural dispersion of
repolarisation and creating the substrate for the development of
ventricular tachycardia/fibrillation.
8
Similar cases of Brugada
electrocardiogram patterns associated with T-wave alternans
during febrile states have been described in several clinical
reports.
9,10
I
II
III
avR
avL
avF
V
1
V
2
V
3
V
4
V
5
V
6
Fig. 1. Case 1: Brugada electrocardiogram pattern with ST-segment and T-wave alternans in the right precordial leads
(body temperature 37.5°C).
I
II
III
avR
avL
avF
V
1
V
2
V
3
V
4
V
5
V
6
Fig. 2. Case 2: Brugada electrocardiogram pattern with ST-segment and T-wave alternans in lead V2 (body temperature
37.6°C).