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Microelectrode Array Recording of Sinoatrial Node Firing Rate to Identify Intrinsic Cardiac Pacemaking Defects in Mice

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Fentanyl-induced Brugada phenocopy: A case report.

Serhat Kesriklioglu¹, Sener Gur¹, Ahmet Taha Sahin²

¹Department of Cardiology, School of Medicine, Necmettin Erbakan University, Konya, Turkiye.

Journal of Electrocardiology

|March 18, 2025

Summary

Brugada phenocopy, mimicking Brugada syndrome, can be caused by external factors. This case highlights high-dose fentanyl transdermal patches as a reversible cause of Brugada phenocopy.

Keywords:

Brugada Phenocopy Brugada syndrome Fentanyl Intoxication

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Published on: November 8, 2024

Area of Science:

Cardiology
Clinical Electrophysiology
Pharmacology

Background:

Brugada Syndrome (BrS) is a genetic cardiac electrical disorder associated with increased risk of sudden cardiac death.
Brugada phenocopy (BrP) describes electrocardiogram (ECG) abnormalities resembling BrS, often triggered by reversible factors.
Distinguishing BrS from BrP is crucial for appropriate patient management and risk stratification.

Purpose of the Study:

To report a case of Brugada phenocopy induced by high-dose fentanyl transdermal patch.
To emphasize the importance of considering medication effects in patients presenting with BrS-like ECG changes.

Main Methods:

Case report of a 45-year-old male.
Review of patient's medical history, ECG findings, and medication use.
Analysis of the temporal relationship between fentanyl patch use and ECG changes.

Main Results:

The patient exhibited ECG findings consistent with Brugada phenocopy.
These ECG changes were temporally associated with the use of a high-dose fentanyl transdermal patch.
Discontinuation of the fentanyl patch led to the resolution of the ECG abnormalities, confirming a phenocopy.

Conclusions:

High-dose fentanyl transdermal patches can induce a reversible Brugada phenocopy.
Clinicians should consider drug-induced causes, such as fentanyl, in the differential diagnosis of Brugada phenocopy.
This case underscores the need for thorough medication review in patients with unexplained ECG changes suggestive of Brugada Syndrome.