Case of Identical Twins Exhibiting Different Type of Brugada Type ECG

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  • Uetake Shunsuke
    Department of Medicine, Division of Cardiology, Nippon Medical School Hospital
  • Miyauchi Yasushi
    Department of Medicine, Division of Cardiology, Nippon Medical School Hospital
  • Hayashi Meiso
    Department of Medicine, Division of Cardiology, Nippon Medical School Hospital
  • Takahashi Kenta
    Department of Medicine, Division of Cardiology, Nippon Medical School Hospital
  • Tsuboi Ippei
    Department of Medicine, Division of Cardiology, Nippon Medical School Hospital
  • Hayashi Hiroshi
    Department of Medicine, Division of Cardiology, Nippon Medical School Hospital
  • Nakatsuji Ayano
    Department of Medicine, Division of Cardiology, Nippon Medical School Hospital
  • Murata Hiroshige
    Department of Medicine, Division of Cardiology, Nippon Medical School Hospital
  • Yamamoto Teppei
    Department of Medicine, Division of Cardiology, Nippon Medical School Hospital
  • Horie Tsutomu
    Department of Medicine, Division of Cardiology, Nippon Medical School Hospital
  • Kato Takao
    Department of Medicine, Division of Cardiology, Nippon Medical School Hospital
  • Mizuno Kyoichi
    Department of Medicine, Division of Cardiology, Nippon Medical School Hospital

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We report a rare case of identical twins that exhibited different types of Brugada type ECG. Forty-one year-old identical twins were referred to our hospital for further evaluation of ECG abnormality. Both of the twins exhibited Brugada type ECG. However, the pattern was different. Twin-A exhibited saddle-back type ST elevation in precordial leads and ventricular pre-excitation suggestive of anteroseptal accessory pathway. During Treadmill exercise testing, ventricular pre-excitation was present only when the heart rate was below 120 bpm. The ST level reduced when ventricular pre-excitation abruptly disappeared, and recovered as ventricular pre-excitation recovered. On the other hand, twin-B exhibited spontaneous coved type ST elevation for 4 mm in precordial leads and no ventricular pre-excitation. Echocardiogram showed no structural abnormality for both. Because both are asymptomatic and had no familial history of cardiac sudden death, they had no further evaluation and were put on regular follow-up. In each follow-up visit, the ECG for twin-A and B always show saddle back and coved type ST elevation, respectively. This is the first report of identical twins with Brugada type ECG. Even in identical twins, the degree and type of ST elevation may differ. Further, ventricular pre-excitation may modify ST elevation in Brugada type ECG.

収録刊行物

  • Journal of Arrhythmia

    Journal of Arrhythmia 27 (Supplement), PE4_057-PE4_057, 2011

    日本不整脈学会

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