Related Experiment Video
Updated: Jun 26, 2026
11:17
Protocol for Repetitive Transcranial Magnetic Stimulation with Symptom Provocation to Treat Obsessive-compulsive Disorder
Published on: November 25, 2025
Provocation of silence.
Jurren M van Opstal1, Paul G A Volders, Harry J G M Crijns
1Department of Cardiology, Maastricht University Medical Centre, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, The Netherlands. jmvanopstal@yahoo.com
Summary
Flecainide can cause dangerous heart rhythm problems, including sinus and ventricular arrest, in patients with undiagnosed SCN5A mutations. This highlights the risk of using antiarrhythmic drugs in patients with Brugada ECG patterns.
Area of Science:
- Cardiology
- Clinical Electrophysiology
- Genetics
Background:
- Atrial fibrillation management often involves antiarrhythmic drugs.
- Brugada ECG patterns can indicate underlying cardiac channelopathies.
- Flecainide is a Class IC antiarrhythmic agent.
Observation:
- A patient developed Brugada electrocardiogram (ECG) changes, sinus arrest, and ventricular arrest after receiving intravenous flecainide for atrial fibrillation.
- Genetic testing identified a SCN5A mutation in the patient.
Findings:
- The SCN5A mutation was linked to the adverse cardiac events observed after flecainide administration.
- Undiagnosed SCN5A mutations may predispose individuals to flecainide-induced sinus arrest and conduction abnormalities.
Implications:
- Clinicians should consider SCN5A mutation screening in patients presenting with Brugada ECG patterns, especially before prescribing Class IC antiarrhythmics.
- Recognition of SCN5A mutations is crucial for preventing potentially fatal arrhythmias associated with antiarrhythmic drug therapy.
- This case underscores the importance of personalized medicine in managing cardiac arrhythmias.
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