Posted on 04/19/2018
image of heart

Brugada syndrome trigger mechanism discovered: a software can electrically reprogram cells and prevent cardiac arrest

MILAN, ITALY--Starting from the Irccs Institute of the Policlino di San Donato Milanese, the potential revolution in the study of cardiac arrests in the world has begun. Today, the JACC (Journal of the American College of Cardiology) publishes an electrical anomaly study that represents the principle of cardiac arrests for ventricular fibrillation. This is the most common pathology for extra-peded ACCs and is referred to as Brugada syndrome. Sudden deaths that are not treated in time with cardiac massage and use of the defibrillator (such as the death of Piermario Morosini) could have – from this new discovery – an additional chance of survival in addition to that guaranteed by the chain of life of international guidelines, which provide for early resuscitation, early defibrillation, call 112, health intervention and hospitalization.

“In this paper – writes in his press note Irccs – it shows that, regardless of symptoms, heart disease has been present since childhood on the epicardial surface of the right ventricle, underlining how the risk of developing potentially fatal ventricular arrhythmias is present throughout the arc of life.” In fact, the Brugada Syndrome presents itself as an electrical anomaly of the groups of cells responsible for making the heart muscle move, and they are usually small restricted groups, surrounded by healthy tissue, to use a clear but slightly technical term “polarized” correctly.

These groups of cells are present in concentric layers, “like an onion”, explains Carlo Pappone, director of the Arbitmology unit of the Ircid Policlinico San Donato. “They are like a central circle characterized by more aggressive cells and predisposed to generate a cardiocirculatory arrest.”

“Patients who survived a cardiac arrest were enrolled – adds Dr. Pappone – and patients with blurred symptoms. In both groups, the islands of abnormal tissue were found to be quite similar when prompted by the administration of ajmaline, a drug that simulates in the laboratory what may happen during the life of these patients: dormant cells that suddenly during a fever or after a meal abundant or during sleep, they can ‘explode’ generating the complete electric paralysis of the heart resulting in sudden arrest and death.” This study, according to Pappone, shows that “the symptoms and the electrocardiogram are not sufficient, alone, to identify patients at risk, since often the first symptom may be sudden death.”

At the Arrhythmology Department of the San Donato Policlinic Institute, innovative technologies have been developed that can perform an extremely accurate mapping of the heart. “It is a software – explains the IRCCS – able to automatically recognize the distribution of anomalous areas and particular probes capable of emitting radiofrequency pulses that ‘clean up like a brush,’ the abnormal surface of the right ventricle, making it electrically normal. I am proud that this technological innovation has been exclusively conceived and realized in Italy, in our research department. This technology – explains Pappone – will be available to the entire scientific world in the coming months, offering all medical specialists the possibility of extending care to an ever-growing population.”

According to Pappone, “this study highlights the possibility of eliminating those islands of electrically anomalous tissue, using short-lived radiofrequency waves, in order to bring those cells back to correct electrical functioning. Until now, 350 patients have undergone this procedure, showing complete normalization of the electrocardiogram even after administration of ajmaline.”

SOURCE: by Martina Tesser, Emergency Live