Brugada syndrome unmasked by sodium channel blockade.

We report the case of a 29-year-old male suffering from recurrent syncope and palpitations. He had a structurally normal heart and his baseline electrocardiogram was normal. His electrophysiologic study revealed an inducible, nonsustained polymorphic ventricular tachycardia on programmed electrical stimulation. With the administration of intravenous Flecainide, there was typical ST-segment elevation in leads V2 and V3, indicative of the Brugada syndrome. He underwent an implantable cardioverter defibrillator implantation. The cardioverter defibrillator delivered an appropriate shock when the patient suffered ventricular fibrillation during follow-up one year later. This report illustrates the role of pharmacologic challenge in the diagnosis of the Brugada syndrome.