Propofol-induced coved-type electrocardiogram during catheter ablation of paroxysmal atrial fibrillation. A case of Brugada syndrome?

We report a case of a young man with paroxysmal atrial fibrillation, in whom a characteristic coved-type Brugada pattern developed during catheter ablation performed under sedation with propofol. After immediate discontinuation of the propofol infusion, coved-type ST-segment elevation gradually resolved and no ventricular arrhythmias occurred. An ajmaline challenge failed to unmask a coved-type electrocardiogram and genetic testing was negative for ion channel mutations related to Brugada syndrome.