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A tale of Brugada. Or the Law of Unintended Consequences 1/n
A 40 yo Afro-Caribbean laborer received a dual-chamber ICD in 2002 for a marked Brugada pattern. He was asymptomatic and had no family history of sudden death.
A 40 yo Afro-Caribbean laborer received a dual-chamber ICD in 2002 for a marked Brugada pattern. He was asymptomatic and had no family history of sudden death.
The Fidelis lead fractured and he received multiple spurious shocks in 2004. The left subclavian vein was closed. They placed a second Fidelis lead from the right side, tunneled to the left pocket. 2/n
The second Fidelis fractured in 2009. He received 48 spurious shocks. The ICD was turned off. Patient developed a florid post traumatic stress disorder. 3/n
He first came to see me shortly thereafter, very distressed. He wanted everything out. The ECG pattern fluctuated. These are CXR and ECG in 2009 4/n 
I thought extraction was a little risky, at least in my hands. I recommended a second opinion from one of the gurus of lead extraction. Patient declined. He chose to keep device in and off. 5/n
He has checked with me every few years. It took him long time to recover from PTSD, but he did. He is 57 now, asymptomatic and in good health. Leads and depleted device still in, This is current ECG. 6/n
I'm afraid the description of the Brugada Syndrome has resulted in net harm to humankind, especially outside Southeast Asia. Please discuss 7/n @drjohnm
