Drug-induced Brugada syndrome

Area of Science:

• Cardiology
• Clinical Electrophysiology
• Pharmacology

Background:

• Brugada syndrome is an inherited cardiac arrhythmia characterized by specific ECG abnormalities and risk of sudden cardiac death.
• ECGs can be normal in affected individuals, complicating diagnosis.
• Diagnostic challenges often require provocative drug testing with sodium channel blockers.

Purpose of the Study:

• To review reported cases and evidence of drug-induced Brugada syndrome.
• To explore the mechanisms and clinical significance of acquired Brugada ECG patterns.
• To understand the role of non-class I anti-arrhythmic agents in inducing Brugada patterns.

Main Methods:

• Literature review of published cases and evidence regarding drug-induced Brugada syndrome.
• Analysis of pharmacological agents reported to induce Brugada ECG patterns.
• Discussion of potential underlying mechanisms, including ion channel dysfunction.

Main Results:

• Sodium channel blockers are established diagnostic tools for Brugada syndrome.
• Numerous other drug classes, including antidepressants and antihistamines, can induce Brugada ECG patterns.
• The prevalence of drug-induced Brugada signs is increasing.

Conclusions:

• Drug-induced Brugada syndrome is an emerging concern with growing clinical relevance.
• Individual susceptibility and latent ion channel dysfunction may contribute to acquired Brugada patterns.
• Further research is needed to confirm the mechanisms and implications of drug-induced Brugada syndrome.