Brugada electrocardiographic pattern elicited by inadvertent flecainide overdose

In a 70-yeor-old man, without clinical suggestion of the hereditary form of the Brugada syndrome, severe flecainide overdose resulted in profound widening of the QRS complex and the development of ST-T abnormalities typical of the Brugada sign. Serial ECGs recorded over a 5-day period revealed a parallel pattern of dynamic intraventricular conduction defect and ST-segment elevation. Resolution of ST-segment elevation lagged behind resolution of the QRS widening by 16-20 hours. Despite the marked Brugado abnormality no arrhythmia occurred and the patient recovered without complications.