Brugada pattern electrocardiogram associated with supratherapeutic phenytoin levels and the risk of sudden death.
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.
Al Aloul
Basel
B
Division of Cardiology, Veterans Affairs Medical Center and University of Minnesota, Minneapolis, Minnesota 55417, USA.
Adabag
A Selcuk
AS
Houghland
Mark A
MA
Tholakanahalli
Venkatakrishna
V
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
D000927:Anticonvulsants; D010672:Phenytoin