In patients presenting with unexpected sick sinus syndrome, the possibility of a Brugada-type ECG should be considered.
May prompt Brugada evaluation in unexplained sinus node dysfunction; case report leaves open need for prospective validation before screening changes.
A 23-year-old man was referred to our center for atrial flutter ablation. After arrhythmia termination sinus node dysfunction unmasked and persisted after 2 months drug-free follow-up. Secondary causes such as antiarrhythmic drug consumption, organic heart disease, or electrolyte disturbance could be excluded. Standard 12-lead ECG showed a coved-type ST elevation in V1-V3, which increased after flecainide provocative test. Following an unexpected sick sinus syndrome, a Brugada-type ECG should be noted.
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Fazelifar et al. (2006) studied this question.
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