Ranolazine-Induced Type 1 Brugada Pattern
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Updated: Jan 18, 2026

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Published on: July 5, 2021
Martino Pepe1, Rocco Tritto1, Roberta Romito1
1Cardiovascular Diseases Section, Interdisciplinary Department of Medicine (DIM), University of Bari "Aldo Moro," Bari, Italy.
Background:
Brugada syndrome (BrS) is a rare inherited arrhythmia disease carrying a variable risk of sudden cardiac death. Diagnosis requires the type 1 Brugada electrocardiographic pattern, which can either be spontaneous or induced by sodium channel-blocking drugs. Ranolazine is an antianginal drug acting on the late sodium current with emerging antiarrhythmic properties; no information is available on the safety of ranolazine use in patients with BrS.
Case Summary:
We present the case of a 48-year-old man with recent history of ST-elevation myocardial infarction and residual microvascular angina who developed a type 1 Brugada pattern after starting therapy with ranolazine.
Discussion:
Ranolazine has been demonstrated to be effective as an antiarrhythmic drug in several conditions in which other sodium-channel blockers are currently employed (eg, atrial fibrillation and type 3 long QT syndrome). Given the mechanism of action, it is plausible to hypothesize a potential role of ranolazine in unmasking the type 1 Brugada pattern.
Take-Home Messages:
Evidence of the safety of ranolazine in patients with BrS is lacking. A possible connection between ranolazine assumption and the unmasking of a type 1 Brugada pattern may question its use in these patients.
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