Transcranial direct current stimulation in patient with J wave syndrome and implantable cardioverter defibrillator

Area of Science:

• Cardiology
• Neurology
• Medical Devices

Background:

• J wave syndrome encompasses Brugada syndrome and early repolarization syndrome (ERS), conditions associated with proarrhythmia, ventricular fibrillation, and sudden cardiac death (SCD).
• Early repolarization syndrome (ERS) is a distinct entity within J wave syndromes, characterized by specific electrocardiographic findings and an increased risk of malignant arrhythmias.
• Implantable cardioverter-defibrillators (ICDs) are crucial for managing patients at high risk of SCD due to cardiac channelopathies.

Observation:

• This case report presents a patient diagnosed with ERS who experienced an aborted sudden cardiac death (SCD).
• The patient also exhibited significant cognitive impairment following the cardiac event.
• The clinical scenario necessitated an investigation into potential therapeutic interventions for cognitive dysfunction.

Findings:

• Transcranial direct current stimulation (tDCS) was considered as a potential treatment to address the patient's cognitive impairment.
• A critical aspect of the investigation involved assessing the safety and efficacy of tDCS in a patient with an implanted cardioverter-defibrillator (ICD).
• The study aimed to determine if tDCS interfered with the normal functioning of the ICD in managing life-threatening arrhythmias.

Implications:

• This case highlights the complex interplay between cardiac channelopathies like ERS, cognitive dysfunction, and the management of implanted cardiac devices.
• Understanding the potential interactions between neurological stimulation techniques, such as tDCS, and ICD function is crucial for patient safety.
• Further research is warranted to explore the safety and efficacy of tDCS in patients with J wave syndromes and co-existing cognitive impairments.