Exercise Testing With Flecainide Demonstrates Provocable Brugada Syndrome

A young man with baseline early repolarization was initiated on flecainide and diltiazem for symptomatic atrial arrhythmias. A treadmill stress test induced a type 1 Brugada electrocardiogram pattern at higher heart rates. Flecainide was discontinued. Genetic testing revealed no SCN5A mutations, and...

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Detalles Bibliográficos
Autores principales: Safabakhsh, Sina, Krahn, Andrew D., Laksman, Zachary
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413235/
https://www.ncbi.nlm.nih.gov/pubmed/34505047
http://dx.doi.org/10.1016/j.cjco.2021.04.001
Descripción
Sumario:A young man with baseline early repolarization was initiated on flecainide and diltiazem for symptomatic atrial arrhythmias. A treadmill stress test induced a type 1 Brugada electrocardiogram pattern at higher heart rates. Flecainide was discontinued. Genetic testing revealed no SCN5A mutations, and a 3-generation pedigree revealed no events of concern. In this case report, we review the use-dependent properties of flecainide. We also discuss how this property can be exploited during exercise stress testing to provoke the diagnostic type 1 Brugada pattern at higher heart rates.

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