© 2004 Fellowship of Postgraduate Medicine
IMAGES IN MEDICINE
Flecainide challenge test for the diagnosis of Brugada syndrome
East Surrey Hospital, Redhill, Surrey, UK
Correspondence to:
Correspondence to:
Dr Manas K Sinha
Department of Cardiology, Atkinson Morley Wing, St George’s Hospital, Blackshaw Road, London SW17 0QT, UK; msinha@sghms.ac.uk
Keywords: Brugada syndrome; flecainide challenge test
| The first 150 words of the full text of this article appear below. |
A 52 year old white man presented having woken up feeling dizzy and unwell. He went to the bathroom and on returning to his bedroom he lost consciousness. He came around spontaneously with no evidence of neurological deficit. He did not have any palpitations. His initial electrocardiogram (ECG) showed 2 mm ST elevation in V2 only (fig 1
). The ST elevation in the right side of the precordial leads was associated with a partial right bundle branch block pattern and varied spontaneously over time. There was no evidence of an acute coronary syndrome. We then performed an intravenous flecainide challenge. His baseline ECG showed minor concave ST elevation in V2 only but then he went on to develop classical Brugada changes with a maximum of 5 mm ST elevation in V2 associated with T wave inversion (fig 2). No arrhythmia was provoked. Coronary angiography was normal and he
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