Wide complex tachycardia and brugada electrocardiographic pattern induced by propafenone: A rare and unpredictable pro-arrhythmic effect

Abstract

Propafenone is a class IC anti-arrhythmic drug used for the rhythm control strategy in atrial fibrillation worldwide, including in Latin America countries. Propafenone intoxication is a potentially life-threatening condition. Ventricular tachycardia and the Brugada electrocardiographic (ECG) pattern are possible pro-arrhythmic manifestations of propafenone poisoning. We present a rare patient case, where therapeutic range dosage of propafenone resulted in a wide complex tachycardia, followed by the Brugada ECG pattern during atrial fibrillation. We discuss the possible mechanisms related to this unusual ECG manifestation.