Brugada syndrome case: difficult differentiation between a concealed form and tricyclic antidepressant-induced Brugada sign

Intern Med. 2009;48(17):1535-9. doi: 10.2169/internalmedicine.48.2370. Epub 2009 Sep 1.

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antidepressive Agents, Tricyclic / adverse effects*
  • Brugada Syndrome / chemically induced*
  • Brugada Syndrome / diagnosis*
  • Brugada Syndrome / physiopathology
  • Diagnosis, Differential
  • Humans
  • Male

Substances

  • Antidepressive Agents, Tricyclic