OBJECTIVES

Brugada syndrome (BrS) is an inherited arrhythmic disease associated with ventricular fibrillation (VF)¹. The specific characteristics of BrS are marked ST-segment elevation in right precordial leads without evidence of ischemia, electrolyte imbalance, and other structural heart diseases¹. The prevalence of BrS has been evaluated in several different populations and was determined to be more common in Asian populations by approximately five times more than Caucasians and 32 times more than Hispanics in a pooled analyzed prevalence¹. The use of intravenous isoproterenol in BrS has been reported in suppressing VF thereby improving quality of life of the patients².

METHODS

The search was conducted in PubMed to identify relevant studies of major medication isoproterenol in BrS. A total of 77 articles and case reports were screened. Of the articles and reports, 17 were assessed for eligibility with a total of 12 being candidate to be included. A total of 8 articles and case reports discussed effectiveness of isoproterenol for VF in BrS.

RESULTS

From the selected articles, total of 37 patients with BrS were treated with Isoproterenol for ventricular fibrillation. Isoproterenol was administrated as a bolus injection intravenously at a dose of 1-2 microgram, followed by continuous infusion of 0.15 – 0.30 microgram/min until baseline heart rate is stabilized. Out of 37 patients, 32 patients were stabilized, which is about 86.4% treatment success rate. The rest of the 5 patients also were stabilized after being treated with combination therapy of isoproterenol plus quinidine.

CONCLUSIONS

Studies were limited to low sample sizes and no truly randomized controlled environment because of the disease’s uncommonness. However, all the studies concluded with consistent effectiveness of isoproterenol for treating ventricular fibrillation in BrS. Isoproterenol should be considered as drug of therapy for VF in BrS.