Flecainide overdose causing a Brugada-type pattern on electrocardiogram in a previously well patient
Cardiology Department, Medway Maritime Hospital, Windmill Road, ME7 5NY Gillingham, UK
Cardiology Department, Medway Maritime Hospital, Windmill Road, ME7 5NY Gillingham, UK
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Fig. 1
The patient's initial ECG illustrating ventricular tachycardia.
Fig. 2
The ECG demonstrating the Brugada-Type picture.
Fig. 3
Sinus rhythm in his follow-up ECG.
The genetic nature of Brugada syndrome has been well reported, with the causative factor being a mutation in the gene encoding cardiac sodium ion channels. Yet, although Brugada syndrome requires specific conditions to be satisfied, a Brugada pattern on electrocardiogram (ECG) has been reported in numerous situations. We describe a typical Brugada-type picture in a previously healthy man, with no cardiac history or risk factors, who presented after a substantial overdose of flecainide. This suggests that a severe overdose of flecainide can sufficiently suppress cardiac sodium ion channels, triggering a Brugada-type pattern in patients without the hereditary form.
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© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
