Arrhythmias induced by dextrose-insulin challenge test in nondiagnostic Brugada ECG patterns.

Introduction: Dynamic ECG changes in Brugada syndrome (BrS) are influenced by several factors, may not be apparent, and can be unmasked by a drug test.

Methods And Results: Four of six patients with nondiagnostic Brugada ECG index patterns underwent a dextrose-insulin challenge test that resulted in J-ST segment elevation and triggered arrhythmias.

Conclusion: Insulin action may be due in part to an outward shift in the K current at the end of action potential phase 1 and the dispersion of repolarization, leading to local re-entry with arrhythmogenicity.

[Recurrent aneurysm of sinus of Valsalva, the world's first case report].

An aneurysm of the sinus of Valsalva is a rare cardiac anomaly (0.09% of cases in autopsy studies) . This article describes the case of a male patient, 58 years old with a history of smoking and surgery for the correction of sinus of Valsalva aneurysm 31 years before, with no record of approach or type of surgery.