Case Reports

Extracorporeal Life Support as a Rescue Measure for Managing Life-Threatening Arrythmia and Brugada Syndrome

^* Pediatric Critical Fellow, Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan, C.S. Mott Children’s Hospital, Ann Arbor, Michigan
^† Certified Clinical Perfusionist, Department of ECMO, University of Michigan, Ann Arbor, Michigan
^‡ Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Toledo College of Medicine and Life Science, Toledo Children’s Hospital, Toledo, Ohio; and
^§ Department of Pediatrics, Division of Pediatric Cardiology, University of Michigan, C.S. Mott Children’s Hospital, Ann Arbor, Michigan

Address correspondence to: Asaad G. Beshish, MD, Pediatric Critical Fellow, Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan, C.S. Mott Children’s Hospital, 1500 East Medical Center Drive, F6790, Ann Arbor, MI 48109-5624. E-mail: abeshish@med.umich.edu

Received: 21 January 2017
Accepted: 11 June 2017

Abstract

We describe the use of extracorporeal cardiopulmonary resuscitation (E-CPR) to transiently stabilize a 3-month-old patient who presented with ventricular tachyarrhythmias leading to spontaneous cardiac arrest. The patient required 4 days of extracorporeal life support (ECLS) where he was diagnosed with probable Brugada syndrome (BS). The patient was discharged home in stable condition after implantable cardioverter defibrillator placement. This case highlights the importance of early transfer to extracorporeal membrane oxygenation (ECMO) center in the setting of unexplained cardiac arrhythmia in a pediatric patient. BS is an autosomal dominant genetic disorder with variable expression characterized by abnormal findings on electrocardiogram (ECG) in conjunction with an increased risk of ventricular tachyarrhythmias and sudden cardiac arrest (SCA). Early management is critical and early consideration to transfer to an institution where extracorporeal life support (ECLS/ECMO) is present to support the patient while further diagnostic work up is in progress is lifesaving.