PYREXIA-INDUCED BRUGADA PHENOCOPY

Area of Science:

• Cardiology
• Genetics
• Electrophysiology

Background:

• Brugada syndrome (BS) is an inherited cardiac arrhythmia associated with SCN5A gene mutations.
• It presents with a characteristic electrocardiogram (ECG) pattern and risk of sudden cardiac death.
• Current management primarily relies on Implantable Cardioverter Defibrillators (ICDs).

Observation:

• A 62-year-old male presented with a type-2 Brugada ECG phenotype during a febrile illness.
• The ECG abnormalities resolved completely upon resolution of the fever.
• This observation suggests a temperature-sensitive nature of the underlying cardiac channelopathy.

Findings:

• The case highlights the potential for fever to unmask or exacerbate the Brugada ECG pattern.
• This temperature sensitivity is consistent with experimental data on SCN5A channel dysfunction.
• The reversible nature of the ECG phenotype in this patient is noteworthy.

Implications:

• Fever may act as a critical trigger for ventricular arrhythmias in susceptible individuals with Brugada syndrome.
• Understanding temperature sensitivity could inform clinical management and risk stratification strategies.
• Further research into temperature-dependent ion channel behavior is warranted for BS patients.