Discuss the cause and electropathophysiological manifestation of an arrhythmia or arrhythmic syndrome.

Discuss the cause and electropathophysiological manifestation of an arrhythmia or arrhythmic syndrome
– critically review the investigation and management of the syndrome (pharmacological, electrical or surgical) for a chosen patient
-debate the current evidence-based management and policy directives implicit in the management of patient and consideration of the and discuss the psychological impact on the patient and his family
-atleast 20 reference ; Chicago style

Patient Information and details
-this is about the 39 y/o male patient, Asian origin, single, with good job as engineer,
has 10 siblings, non smoker, non drinker , no significant past medical history other than a previous anaemia 20yrs ago
-admitted due to collapsed episode whilst driving, suffer minor injuries.,
-investigation : CXR -normal; ECG on admission – showed type 2 Brugada pattern
Coronary angiogram : normal coronary artery
ECHO – normal / no abnormality, Cardiac MRI -normal / no abnormality;

Flecainide challenge done twice and both positive and produced type 1 Brugada ECG pattern done by arrhythmia nurse and reviewed by cardiologist

-He underwent Implantation of single chamber ICD but it takes 2 weeks before he was convinced to have ICD. Brugada syndrome and the treatment by implanting ICD was explained to him and to his family by Consultant Cardiac Electrophysiologist and by Arrhytmia Nurse Specialist. Initially patient was on denial and cannot believe he has this syndrome. Patient was worried that he is young, about his career / job, future family or children, his other 10 siblings. At first, he was hesitant and declined but eventually agreed
to have ICD after he was convinced again by cardiologist.

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