Brugada pattern masquerading as ST-segment elevation myocardial infarction in flecainide toxicity

• Main Authors: Lovely Chhabra, David H. Spodick
• Format: Article
• Language: English
• Published: Elsevier 2012-07-01
• Series: Indian Heart Journal
• Subjects: Brugada pattern; STEMI; Flecainide toxicity; Electrocardiogram
• Online Access: http://www.sciencedirect.com/science/article/pii/S0019483212000399

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.