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Wide complex tachycardia and brugada electrocardiographic pattern induced by propafenone: A rare and unpredictable
Acácio Fernandes Cardoso1, Luiz Claudio Behrmann Martins2, Cynthia Aparecida da Silva Rocha2
1Electrocardiology Sector, Central Institute of Clínicas Hospital, Faculty of Medicine, University of São Paulo (HCFMUSP), Brazil; Cardiac Electrophysiology Service, Santa Casa Hospital from Santos/São Paulo, Brazil.
Abstract:
Propafenone is a class IC anti-arrhythmic drug used for the rhythm control strategy in atrial fibrillation worldwide, including in Latin America countries. Propafenone intoxication is a potentially life-threatening condition. Ventricular tachycardia and the Brugada electrocardiographic (ECG) pattern are possible pro-arrhythmic manifestations of propafenone poisoning. We present a rare patient case, where therapeutic range dosage of propafenone resulted in a wide complex tachycardia, followed by the Brugada ECG pattern during atrial fibrillation. We discuss the possible mechanisms related to this unusual ECG manifestation.
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