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J Thorac Cardiovasc Surg 2008;136:1593-1595
© 2008 The American Association for Thoracic Surgery

Brief Communication

The unmasking of a Brugada phenotype after pulmonary resection: A case report and implications for postoperative management

Saila P. Nicotera, MD, MPH*, Min P. Kim, MD, Malcolm M. Decamp, MD

Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass

Received for publication July 3, 2007; accepted for publication October 19, 2007.

* Address for reprints: Saila Pillai Nicotera, MD, MPH, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215. (Email: snicoter@bidmc.harvard.edu).

The first 20% of the full text of this article appears below.

The unmasking of latent arrhythmogenic diseases after general thoracic surgery has, to date, not been described. We present a patient in whom a Brugada pattern became evident on electrocardiogram after pulmonary resection.

Clinical Summary

A 78-year-old white man was diagnosed with non–small cell lung cancer by transthoracic fine-needle aspirate. His medical history included type I diabetes mellitus, hypothyroidism, emphysema, and a distant history of cholangiocarcinoma treated with surgery, chemotherapy, and radiation. He had a 30-pack-year smoking history and stopped using tobacco 20 years ago.

Staging evaluation, including magnetic resonance imaging of the brain, positron emission tomography-computed tomography scan, flexible bronchoscopy, and mediastinoscopy, revealed node-negative poorly differentiated stage IA non–small cell lung cancer. The patient enrolled in a clinical trial studying the efficacy of pre-resection administration of amiodarone in reducing postoperative atrial dysrhythmias. As part of the study protocol 7 days before his operation, the patient commenced taking 200 mg of amiodarone orally twice per day. He underwent an uncomplicated left thoracotomy and . . . [Full Text of this Article]






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