Isolated tramadol overdose associated with Brugada ECG pattern

Pacing Clin Electrophysiol. 2012 Aug;35(8):e219-21. doi: 10.1111/j.1540-8159.2010.02924.x. Epub 2010 Oct 7.


Tramadol is a commonly prescribed synthetic opioid analgesic. In humans, electrocardiogram (ECG) changes consistent with sodium-channel blockade have not been described in overdoses with tramadol. We report a case of isolated tramadol overdose associated with a Brugada ECG pattern. A review of the literature reveals no previous human cases of tramadol overdose causing ECG changes consistent with sodium-channel blockade. However, in vitro blockade of sodium-channels has been demonstrated with high concentrations of tramadol. Tramadol overdose should be recognized as a cause for the manifestation of a Brugada ECG pattern in the setting of suicidal intoxication.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / poisoning*
  • Brugada Syndrome / chemically induced*
  • Humans
  • Male
  • Middle Aged
  • Naloxone / therapeutic use
  • Narcotic Antagonists / therapeutic use
  • Prescription Drug Misuse*
  • Sodium Channel Blockers / adverse effects
  • Tramadol / administration & dosage
  • Tramadol / poisoning*
  • Treatment Outcome


  • Analgesics, Opioid
  • Narcotic Antagonists
  • Sodium Channel Blockers
  • Naloxone
  • Tramadol