The Unmasking Effect: Propofol-Induced Brugada Pattern in a Critically Ill Patient

Abstract

Brugada syndrome is a known cause of dysrhythmias and sudden cardiac death. It is linked to mutations in myocardial sodium channel leading to hyperexcitable cardiac myocytes. The use of this sedative has been linked to the development of inducible Brugada via blockade of sodium currents in cardiac myocytes. Although propofol is usually avoided in patients with known Brugada syndrome, some patients might have undiagnosed Brugada syndrome and thus are at risk for complications. We present a case of propofol induced Brugada in a critically ill patient.

Propofol infusion syndrome (PRIS) in neuropatients: Early initiation of renal replacement therapy: Case series and literature review

“…Further, the ventricular arrhythmias associated with PRIS can be attributed to the pro-arrhythmic effects of excess serum FFAs. Several cardiovascular manifestations may occur, such as right bundle branch block, hypotension, Brugada-like syndrome ECG (elevated ST segment and widening of the QRS complex), ventricular arrhythmia, ventricular tachycardia, supraventricular tachycardia, atrial fibrillation, cardiogenic shock and asystole [8,9].…”