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January 1, 2025Case Reports in Cardiology0 citationsOpen Access

Fever, Syncope, and the Brugada Dilemma: Navigating the Complexities of ICD Decision‐Making in an Atypical Presentation

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LDLorna DevkotaMHMichael Hoffer-HawlikFYFelix Yang

Key Result

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.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
20-year-old male with fever, syncope, and Type 1 Brugada pattern on EKG
I
Intervention
Implantable cardioverter defibrillator (ICD) placement

This case underscores the diagnostic and management challenges in intermediate-risk Brugada syndrome patients presenting with fever and syncope.

Abstract

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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Cite This Study

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.

synapsesocial.com/papers/6a0cfb5632f3c40b5ccbafe8https://doi.org/10.1155/cric/5536305
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