title: Brugada pattern masquerading as ST-segment elevation myocardial infarction in flecainide toxicity.
abstract: Flecainide (a class 1c antiarrhythmic) produces a dose-dependent decrease in intracardiac conduction. Its well known common electrocardiographic effects are prolongation of PR and QT intervals and the QRS complex duration. We report a case of flecainide toxicity in an elderly female who presented with a type 1 Brugada pattern who essentially had a previously normal ECG pattern on therapeutic dose of flecainide therapy. The case describes a rare electrocardiographic abnormality induced by flecainide toxicity which otherwise could be easily misinterpreted as a ST-segment elevation myocardial infarction (STEMI) without lack of expertise and high clinical suspicion.
authors.affiliation: Department of Internal Medicine, University of Massachusetts Medical School, Worcester, MA 01608, USA. lovids@hotmail.com
authors.forename: Lovely
authors.initials: L
authors.lastname: Chhabra
authors.forename: David H
authors.initials: DH
authors.lastname: Spodick
mesh_terms: D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000494:pharmacology / Q000506:poisoning*; D053840:Brugada Syndrome / Q000175:diagnosis*; D004562:Electrocardiography; D005260:Female; D005424:Flecainide / Q000494:pharmacology / Q000506:poisoning*; D006329:Heart Conduction System / Q000187:drug effects*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis*
chemical_list: D000889:Anti-Arrhythmia Agents; D005424:Flecainide