Latent Brugada syndrome revealed with propafenone

Abstract

Brugada syndrome (BrS) is an inherited channelopathy known since the 1990s. Its diagnosis can sometimes be complex, since it typically presents the image of complete right bundle branch block in the ECG, with persistent ST-segment elevation being characteristic, which should make us suspect the entity. Early diagnosis is important since it is considered responsible for >10% of sudden deaths in patients without known heart disease. We present the case of a 78-year-old woman, under treatment with propafenone for 25 years, who presented recurrent syncope. Review of her ECG’s showed fluctuations between the characteristic
pattern of BrS while taking propafenone and the normal pattern when not taking propafenone.