title: Brugada pattern electrocardiogram associated with supratherapeutic phenytoin levels and the risk of sudden death.
abstract: The emergence of Brugada pattern on electrocardiogram in response to class IA or IC antiarrhythmic agents is widely utilized to diagnose concealed Brugada syndrome and recognized as a risk factor for sudden death. Phenytoin, a class IB antiarrhythmic agent, has not been reported to induce Brugada pattern. We report a patient who presented with Brugada electrocardiogram at supratherapeutic phenytoin level. Considering that patients with syncope may falsely be labeled to have seizures and some epilepsy patients are at increased risk of sudden death, all patients with supratherapeutic phenytoin level should be evaluated with an electrocardiogram for emergence of Brugada pattern.
authors.affiliation: Division of Cardiology, Veterans Affairs Medical Center and University of Minnesota, Minneapolis, Minnesota 55417, USA.
authors.forename: Basel
authors.initials: B
authors.lastname: Al Aloul
authors.forename: A Selcuk
authors.initials: AS
authors.lastname: Adabag
authors.forename: Mark A
authors.initials: MA
authors.lastname: Houghland
authors.forename: Venkatakrishna
authors.initials: V
authors.lastname: Tholakanahalli
mesh_terms: D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects*; D053840:Brugada Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control; D004562:Electrocardiography; D006801:Humans; D008297:Male; D010672:Phenytoin / Q000008:administration & dosage* / Q000009:adverse effects*; D012307:Risk Factors
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin