Drug-induced Brugada syndrome: Case report

Brugada syndrome (BrS) is an inherited clinical and electrocardiographic syndrome, related to ion channelopathies and associated with an increased risk of sudden cardiac death. The cornerstone in diagnosis remains a spontaneous type 1 Brugada-pattern on the electrocardiogram (ECG), including J point elevation of ≥ 2 mm, coved-type ST segment elevation and T wave inversion in right precordial leads. Similar ECG changes, induced by antiarrhythmic therapy, should be considered as diagnostic when combined with a documented polymorphic ventricular tachycardia or ventricular fibrillation episode, arrhythmogenic syncope, nocturnal agonal breathing or a family history of sudden cardiac death or BrS. The article represents a clinical case of drug-induced type 1 Brugada-pattern in the settings of antiarrhytmic treatment using 1C class sodium channel blocker ethacizine in a female without additional BrS criteria, with negative genetic testing results and the ECG normalization after drug withdrawal.