Fever can unmask a Brugada-like ECG pattern, highlighting the temperature-dependent nature of the ionic mechanisms in Brugada syndrome.
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Alerts clinicians to fever as ECG unmasker in suspected Brugada; leaves open need for prospective validation of pilsicainide testing.
Brugada syndrome is characterized by right bundle branch block morphology and ST-segment elevation in the right precordial leads and a propensity to develop ventricular arrhythmias. Mutations in a cardiac sodium channel gene have been linked to this syndrome, and the ionic mechanisms responsible for the electrocardiographic phenotype are temperature-dependent. This case report describes a patient in whom a typical Brugada ECG pattern developed during fever and could be reproduced at normal body temperature by administration of pilsicainide.
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Wakita et al. (2004) studied this question.
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