title: Brugada syndrome case: difficult differentiation between a concealed form and tricyclic antidepressant-induced Brugada sign.
abstract: 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.
authors.affiliation: Cardiovascular Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical College, Asahikawa.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Tashiro
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sato
authors.forename: Ahmed Karim
authors.initials: AK
authors.lastname: Talib
authors.forename: Ali Karim
authors.initials: AK
authors.lastname: Talib
authors.forename: Erika
authors.initials: E
authors.lastname: Saito
authors.forename: Minako
authors.initials: M
authors.lastname: Okura
authors.forename: Masaru
authors.initials: M
authors.lastname: Yamaki
authors.forename: Naoki
authors.initials: N
authors.lastname: Nakagawa
authors.forename: Naka
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Ota
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Tanabe
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Kazumi
authors.initials: K
authors.lastname: Akasaka
authors.forename: Junichi
authors.initials: J
authors.lastname: Kawabe
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kawamura
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Hasebe
mesh_terms: 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
chemical_list: D000929:Antidepressive Agents, Tricyclic