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Brugada syndrome, manifested by propafenone induced ST segment elevation.

E Aksay1, T Okan, S Yanturali

  • 1Department of Emergency Medicine, Dokuz Eylul University Hospital, Turkey. ersin.aksay@deu.edu.tr

Emergency Medicine Journal : EMJ
|September 29, 2005
PubMed
Summary

Brugada syndrome, a cause of sudden cardiac death, was diagnosed in a patient after propafenone use for atrial fibrillation. Emergency physicians should recognize its ECG pattern for prompt diagnosis and management.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Emergency Medicine

Background:

  • Brugada syndrome is a genetic disorder associated with sudden cardiac death in individuals without ischemic heart disease.
  • Atrial fibrillation is a common arrhythmia requiring management, often with antiarrhythmic drugs.
  • Propafenone is an antiarrhythmic medication used for chemical cardioversion.

Observation:

  • A 43-year-old male developed Brugada syndrome following propafenone administration for new-onset atrial fibrillation.
  • The patient presented with the classic electrocardiographic findings of Brugada syndrome.

Findings:

  • Propafenone can unmask or induce Brugada syndrome in susceptible individuals.
  • The diagnosis was confirmed after the administration of the drug.

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Implications:

  • Emergency physicians must consider Brugada syndrome in patients presenting with specific ECG abnormalities, particularly right bundle branch block and ST elevation in right precordial leads.
  • Early recognition of Brugada syndrome is critical for preventing sudden cardiac death.
  • This case highlights the importance of drug-induced arrhythmias and the need for careful patient selection in cardioversion procedures.