Brugada syndrome case: difficult differentiation between a concealed form and tricyclic antidepressant-induced Brugada sign.
We describe a case of Brugada syndrome, in which recurrent syncope with convulsive seizures was induced after antidepressant treatment. The patient had been treated with five kinds of psychotropic drugs. The twelve-lead ECG after the syncope exhibited an RSR'-pattern in the precordial leads, however, a coved type ST-segment elevation was induced by a pilsicainide test. Although ventricular fibrillation was not induced in the electrophysiologic study, an ICD implantation was considered as the recommended therapy since Brugada syndrome unmasked by antidepressants could not be ruled out. The possible contribution of antidepressants to Brugada type ST-segment changes is discussed.
Tashiro
Naohiko
N
Cardiovascular Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical College, Asahikawa.
Sato
Nobuyuki
N
Talib
Ahmed Karim
AK
Talib
Ali Karim
AK
Saito
Erika
E
Okura
Minako
M
Yamaki
Masaru
M
Nakagawa
Naoki
N
Sakamoto
Naka
N
Ota
Hisanobu
H
Tanabe
Yasuko
Y
Takeuchi
Toshiharu
T
Akasaka
Kazumi
K
Kawabe
Junichi
J
Kawamura
Yuichiro
Y
Hasebe
Naoyuki
N
D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects*; D053840:Brugada Syndrome / Q000139:chemically induced* / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male
D000929:Antidepressive Agents, Tricyclic