Brugada syndrome (BS) is an arrrhythmogenic disease characterized by a structurally normal heart and an increased risk of sudden cardiac death from ventricular fibrillation. BS is found worldwide but it is the most common cause of sudden cardiac death in young men in Thailand and other countries in Southeast Asia. The disease has been prevalent in Northeastern Thailand. Most victims were healthy young men who died unexpectedly at night. The automatic implantable cardioverter defibrillator (AICD) is currently the only proven treatment that can prevent sudden death. However, the device does not prevent but terminate the VF. (written by Buncha Sunsaneewitaykul, MD, MSc )

Chananya Chaiyaumporn, MD.

What is atrial fibrillation?

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia which causes a fast and erratic heartbeat. If you have AF

·         Your heart rate is usually a lot faster than normal.
·         Your heartbeat is irregular - that is, an abnormal heart rhythm (an arrhythmia).
·         The force of each heartbeat can vary in intensity.

What happens is that the normal controlling timer in the heart is overridden by many random electrical impulses that fire off from the heart muscle in the atria. The atria then fibrillate. This means that the atria only partially contract - but very rapidly. Only some of these impulses pass through to the ventricles in a haphazard way.

Chayanute Suwanpen MD.

What is Lai Tai?

Lai Tai or sudden unexplained (unexpected) nocturnal death syndrome (SUND) is called for death at night caused by ventricular fibrillation (VF). Symptoms usually occur during sleep and show as an abnormal breathing like a sleepwalking while facing nightmare (term of Lai refers to sound like a sleepwalking and term of Tai refers to death). Lai Tai often happen in healthy young men who looked normal before going to bed and later found dead in the next day morning. Theseare a source of folklore about ghost of widows caught young men to live with them in the northeast of Thailand.

From studies in survivors, Lai Tai has no anatomical abnormality in heart but it associated with an abnormal pattern in electrocardiogram (ECG) called Brugada pattern which gives Lai Tai is called Brugada syndrome in medical term.

Details are only in Thai Page.

Atrial fibrillation is an irregular heart beat which can cause blood clot in the heart and embolic stroke. Prevention of stroke can be managed by anticoagulation (Blood thinner). However, some patients are contraindicated to the blood thinner. Left atrium appendage (LAA) occluder device is a new technology developed to occupy the space in the heart (LAA) where the blood clot forms as an alternative treatment for blood thinner. The device placement can be performed by catheter technique via the access of the artery beneath the groin area without a need for open heart surgery. The length of hospital stay is 1-2 days.

Cardiac Center at King Chulalongkorn Memorial Hospital is the first in Thailand successfully performed LAA occlude device placement in two patients with atrial fibrillation. More details are in Thai.