Brugada Type I ECG Pattern after Flecainide Intoxication

Flecainide (a class 1c antiarrhythmic) is known for different electrocardiographic effects like prolongation of PR and QT intervals and the QRS complex duration. We report a case of Brugada syndrome, after flecainide intoxication in an elderly female who presented with a non-fatal suicide. Methods: On admission the serum concentration of flecainide was tested. Several Electrocardiograms (ECG) were made. Six weeks after discharge and Ajmaline provocation test was performed. Results: The serum concentration of flecainide measured was 2.90 mg/l (therapeutic range 0.45 ? 0.90 mg/L, toxic effects are observed from 1 mg/L [1]. On the ECG, Brugada pattern type I was observed. In-hospital monitoring showed no abnormalities. Ajmaline provocation test was negative for Brugada. Conclusion: We present a case of Brugada pattern, with the suggestion of a congenital Brugada syndrome, after flecainide overdose in a patient, with false-negative Ajmaline provocation test.