Brugada pattern electrocardiogram associated with supratherapeutic phenytoin levels and the risk of sudden death

Pacing Clin Electrophysiol. 2007 May;30(5):713-5. doi: 10.1111/j.1540-8159.2007.00734.x.


The emergence of Brugada pattern on electrocardiogram in response to class IA or IC antiarrhythmic agents is widely utilized to diagnose concealed Brugada syndrome and recognized as a risk factor for sudden death. Phenytoin, a class IB antiarrhythmic agent, has not been reported to induce Brugada pattern. We report a patient who presented with Brugada electrocardiogram at supratherapeutic phenytoin level. Considering that patients with syncope may falsely be labeled to have seizures and some epilepsy patients are at increased risk of sudden death, all patients with supratherapeutic phenytoin level should be evaluated with an electrocardiogram for emergence of Brugada pattern.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged, 80 and over
  • Anticonvulsants / administration & dosage*
  • Anticonvulsants / adverse effects*
  • Brugada Syndrome / diagnosis*
  • Brugada Syndrome / physiopathology*
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control
  • Electrocardiography
  • Humans
  • Male
  • Phenytoin / administration & dosage*
  • Phenytoin / adverse effects*
  • Risk Factors


  • Anticonvulsants
  • Phenytoin