Brugada-Phenocopy Induced by Propafenone Overdose and Successful Treatment: A Case Report

Brugada syndrome is an inherited arrhythmogenic disease that may cause sudden cardiac death due to ventricular fibrillation in young adults. Brugada syndrome caused by propafenone intoxication has been noted rarely in the literature. We report a rare case, Brugada phenocopy due to propafenone intoxi...

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Bibliographic Details
Published in:Balkan medical journal 2017-09, Vol.34 (5), p.473-475
Main Authors: Arı, Mehmet Emre, Ekici, Filiz
Format: Article
Language:English
Subjects:
Adolescent
Adolescent Behavior - psychology
Adverse drug reactions
Anticonvulsants - pharmacology
Anticonvulsants - therapeutic use
Brugada phenocopy
Brugada Syndrome - etiology
Brugada-like electrocardiography pattern
Care and treatment
Case Report
Case studies
Chicago
children
Complications and side effects
Dosage and administration
Electrocardiography - methods
Electrocardiography, Ambulatory
Female
Humans
Midazolam - pharmacology
Midazolam - therapeutic use
Propafenone
Propafenone - adverse effects
Risk factors
Seizures - drug therapy
Seizures - etiology
Sodium Channel Blockers - adverse effects
Suicide, Attempted - psychology
Tıp
Treatment Outcome
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Summary:Brugada syndrome is an inherited arrhythmogenic disease that may cause sudden cardiac death due to ventricular fibrillation in young adults. Brugada syndrome caused by propafenone intoxication has been noted rarely in the literature. We report a rare case, Brugada phenocopy due to propafenone intoxication and its treatment. A 15-year-old girl having a seizure was brought to the emergency room. She took 1.5 g propafenone (Rythmol, Abbott, Chicago, IL, USA) for suicidal intention. She had metabolic acidosis. Long QRS interval and ST elevation in leads V1 through V3 were seen on electrocardiography. After bicarbonate infusion for 4 hours, haemodynamic and neurologic findings were recovered, and all electrocardiography abnormalities disappeared. The Brugada-like electrocardiography pattern was not recognized in her surface and 24-hour Holter electrocardiography at follow-up. Ajmaline challenge test was negative 2 weeks later. Absence of symptoms and documented ventricular tachycardia, negative challenge test, and a negative family history demonstrated that the Brugada phenocopy was a transient finding in this case and related to propafenone intoxication.
ISSN:2146-3123
2146-3131
DOI:10.4274/balkanmedj.2016.1185