Abstract:
:Brugada syndrome (BrS) is a common occult cause of sudden cardiac arrest in otherwise healthy-appearing adults. The pathognomonic electrocardiographic pattern may be unmasked only by certain medications, many of which are unknown. We report a case of a depressed but otherwise healthy man with an asymptomatic right bundle branch block on electrocardiography who experienced antidepressant-induced BrS and ultimately recovered with transcranial magnetic stimulation (TMS). After an initial trial of nortriptyline, the patient's depressive symptoms improved; however, he experienced a syncopal event and was subsequently diagnosed as having BrS. Cross titration to bupropion, which had not previously been known to exacerbate BrS, was followed by another cardiac event. As a result, the patient was referred for TMS as a substitute for pharmacotherapy. After 31 TMS sessions over 8 weeks, the patient demonstrated significant improvement by subjective report and objective reduction in his Patient Health Questionnaire-9 scores from 10 (moderate) to 1 (minimal). Transcranial magnetic stimulation is a Food and Drug Administration-approved nonpharmacologic treatment for depression. Given the potential lethality of BrS with known and unknown psychopharmacologic agents, providers should consider TMS as first-line therapy in this patient population. Bupropion should be added to the list of agents known to exacerbate this disease.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Alampay MM,Haigney MC,Flanagan MC,Perito RM,Love KM,Grammer GGdoi
10.1016/j.mayocp.2014.08.010subject
Has Abstractpub_date
2014-11-01 00:00:00pages
1584-7issue
11eissn
0025-6196issn
1942-5546pii
S0025-6196(14)00744-7journal_volume
89pub_type
杂志文章abstract::Hypothyroidism and hyperthyroidism are common medical disorders that are often accompanied by diverse types of neurologic and neuromuscular dysfunction. Although some of these associated disorders are well known to physicians, others are not. All of these neurologic manifestations are important because they can severe...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
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abstract:OBJECTIVE:To assess the effects of glutathione on pain-free walking distance (PFWD) and hemodynamic parameters in patients with peripheral artery disease. PATIENTS AND METHODS:Forty patients with Fontaine stage II peripheral artery disease who were seen between September 2000 and March 2001 at the vascular laboratory ...
journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,随机对照试验
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
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pub_type: 杂志文章
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journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
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