Drug-induced Brugada syndrome: Clinical characteristics and risk factors
Section snippets
Methods
The website http://www.BrugadaDrugs.org has up-to-date and free access to a consensus statement on the safe use of drugs in Brugada syndrome.9 At initiation of the website in 2009, an extensive literature review was performed on published associations between drugs and Brugada syndrome.9 An advisory board of experts periodically reviews up-to-date information collected during weekly literature searches. The advisory board labels drugs as “drugs to be avoided” or “drugs preferably avoided.” The
Results
We identified 74 cases of Brugada syndrome induced by 27 noncardiac drugs in 62 reports (see Online Supplementary Material for references). Among these cases, 36 (49%) were induced by psychotropic drugs, 20 (27%) were induced by analgesic–anesthetic drugs, and 18 (24%) were induced by other noncardiac drugs. The most frequently reported agent was intravenous propofol, which accounted for 20% of cases. The most frequently reported oral agents were lithium and amitriptyline (accounting for 20%
Discussion
Drug-induced LQTS was first recognized half a century ago, whereas drug-induced Brugada syndrome was recognized only recently.19 This does not make drug-induced Brugada syndrome any less important.9 In fact, long-term use of nortriptyline (an antidepressant that blocks the cardiac sodium channel) is associated with a 5-fold increased risk of sudden death,20 probably caused, at least in part, by drug-induced Brugada syndrome.20 Thus, better characterization of this phenomenon is needed. With
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Post-finasteride syndrome: a surmountable challenge for clinicians
2020, Fertility and SterilityCitation Excerpt :Similarly, other recognized drug-induced syndromes include: long QT syndrome (LQTS) (202–206), Brugada syndrome (208), hematologic Syndromes (209) and Fanconi’s syndrome (210). Contrary to PFS, persistent side effects arising from treatment with other drugs are well-recognized and accepted (201–211) while those persistent adverse side effects arising from finasteride treatment are fiercely denied. If drug-induced syndromes, other than finasteride, are well recognized by the medical community, it raises a fundamental question why the resistance by the clinical profession to recognizing PFS?
Epinephrine Administered for Anaphylaxis Unmasking a Type 1 Brugada Pattern on Electrocardiogram
2019, Journal of Emergency MedicineCitation Excerpt :The Brugada pattern may be drug-induced, and as the underlying pathology relates to a channelopathy, pharmaceutical agents, and antidysrhythmic medications in particular, can induce and thereby diagnose Brugada syndrome (9). Prior to Brugada syndrome being described, the Cardiac Arrhythmia Suppression trial performed in 1991 showed flecainide and encainide (sodium channel blockers) increased antidysrhythmic deaths in patients who had suffered myocardial infarctions, which may have been due to unmasking of Brugada syndrome (10,11). Postema et al. compiled a list of drugs that may be prodysrhythmic in patients with Brugada syndrome (12).
2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society
2018, Journal of the American College of Cardiology