A Clinical Study Starting from an Encounter with a Patient

Abstract

The story of this clinical study began with a patient I encountered as a post-graduate student on night duty at Juntendo University Hospital in 1989. The patient was diagnosed as idiopathic ventricular fibrillation (IVF) with incomplete right bundle branch block and a bizarrely shaped ST segment elevation in V_1-3. He had a history of sick sinus syndrome (SSS) one year earlier. Three years after that encounter, the Brugada brothers reported eight patients with IVF whose ECG findings were very similar to those of my patient, and this syndrome was later named Brugada syndrome (BrS). It is now known that there are many individuals with BrS in Japan and across Asia, and regrettably the first patient’s report was not released in Japan. With the later progress in genomic research it has become apparent that a single gene mutation could be a cause of both BrS and SSS. We have begun a clinical study of the association between BrS and SSS and have published several papers about this issue. My first patient with BrS and SSS has been doing well without syncope for over 30 years.