title: Drug-induced Brugada syndrome.
abstract: Brugada syndrome is an inherited cardiac arrhythmia condition characterized by (i) coved ST-elevation and J point elevation of at least 2 mm in at least two of the right precordial ECG leads (V1-V3) and (ii) ventricular arrhythmias, syncope, and sudden death. Patients with Brugada syndrome or suspected mutation carriers can have normal ECG recordings at other times. In these cases, a diagnostic challenge with a sodium channel blocker such as ajmaline, flecainide, or pilsicainide may induce the full-blown type 1 ECG pattern and support the diagnosis. However, recently, many other pharmacological agents not related to class I anti-arrhythmic agents have been reported to induce Brugada ECG patterns including tricyclic antidepressants, fluoxetine, lithium, trifluoperazine, antihistamines, and cocaine. As published reports of the drug-induced Brugada sign have become increasingly prevalent, there is growing interest in the mechanisms responsible for this acquired ECG pattern and its clinical significance. It is possible that drug-induced Brugada syndrome may be due to an individual susceptibility that favours drug-induced ECG abnormalities, possibly as a result of an increase in a latent ion channel dysfunction similar to that in drug-induced long QT syndrome. However, further evidence is needed to confirm this postulation. In this paper, we will review the cases and evidence of drug-induced Brugada syndrome reported in the literature.
authors.affiliation: Department of Cardiology, Heart and Lung Centre, Prince Court Medical Centre, 39, Jalan Kia Peng, Kuala Lumpur 50450, Malaysia. ygyap@aol.com
authors.forename: Yee Guan
authors.initials: YG
authors.lastname: Yap
authors.forename: Elijah R
authors.initials: ER
authors.lastname: Behr
authors.forename: A John
authors.initials: AJ
authors.lastname: Camm
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D053840:Brugada Syndrome / Q000139:chemically induced* / Q000517:prevention & control*; D002316:Cardiotonic Agents / Q000009:adverse effects*; D006329:Heart Conduction System / Q000187:drug effects*; D006801:Humans
chemical_list: D000889:Anti-Arrhythmia Agents; D002316:Cardiotonic Agents