Key result
Primary prevention ICD manages a 20-year-old male with fever-induced Type 1 Brugada pattern and syncope.
Why the study?
Diagnostic and management challenges persist in intermediate-risk Brugada syndrome patients, particularly regarding ICD decision-making in atypical presentations unmasked by fever.
Case Report (n=1)
This case underscores the diagnostic and management challenges in intermediate-risk Brugada syndrome patients presenting with fever and syncope.
Supports individualized ICD decisions in fever-unmasked Brugada with syncope; leaves open optimal risk stratification for primary prevention.
Brugada syndrome (BrS) is a rare inherited cardiac channelopathy associated with ventricular arrhythmias and sudden cardiac death (SCD), often in individuals with structurally normal hearts. It is diagnosed by a Type 1 electrocardiographic (EKG) pattern-coved ST-segment elevation in the right precordial leads. Fever is a known trigger that can unmask Brugada patterns by worsening sodium channel dysfunction. We present the case of a 20-year-old male with a fever and an episode of syncope prior to admission who had an EKG showing a Type 1 Brugada pattern. Procainamide challenge was negative, but an atypical right bundle branch block suggested sodium channel dysfunction. Despite the absence of structural heart disease, an implantable cardioverter defibrillator (ICD) was placed for primary prevention of SCD. This case underscores the diagnostic and management challenges in intermediate-risk BrS patients.
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Devkota et al. (2025) conducted a case report in Brugada syndrome (n=1). Implantable cardioverter defibrillator (ICD) was evaluated. An implantable cardioverter defibrillator was placed for primary prevention of sudden cardiac death in a 20-year-old male with fever-induced Type 1 Brugada pattern and syncope.
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