IJCS | Volume 32, Nº1, January/ February 2019

93 1. Brugada,J. Brugada. Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. Amulticenter report. J AmColl Cardiol. 1992;20(6):1391-6. 2. Anselm DD, Evans JM, Baranchuk A. Brugada phenocopy: a new electrocardiogram phenomenon. World J Cardiol. 2014;6(3):81-6. 3. Dendramis G. Brugada Syndrome and Brugada Phenocopy. The importance of a differential diagnosis. Int J Cardiol. 2016May 1;210:25-7. 4. Kocabas U, Hasdemir C, Kaya E, Turkoglu C, Baranchuk A. Brugada syndrome, Brugada phenocopy or none? Ann Noninvasive Electrocardiol. 2017 Nov;22(6). doi: 10.1111/anec.12470. 5. Anselm DD, Baranchuk A. Brugada phenocopy in the context of pulmonary embolism. Int J Cardiol. 2013 Sep 20;168(1):560. 6. Gottschalk BH, AnselmDD, Baranchuk A. Ischemic Brugada phenocopy during ablation of ventricular tachycardia. J Arrhythm. 2016;32(2):156. 7. Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, et al; ESC Scientific Document Group. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for theManagement of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J. 2015;36(41):2793-867. 8. Wo ż akowska-Kapłon B, St ę pie ń -Walek A. Propafenone overdose: Cardiac arrest and full recovery. Cardiol J. 2010;17(6):619-22. 9. Nishizaki M, Sakurada H, Yamawake N, Ueda-Tatsumoto A, Hiraoka M. Low risk for arrhythmic events in asymptomatic patients with druginduced type 1 ECG: do patients with drug-induced Brugada type ECG have poor prognosis? Circ J. 2010;74(11):2464-73. 10. Baszak J, Drozd J, Chlebus D. Suicidal intoxication with propranolol and propafenone in a 19 year old female: case report. Kardiol Pol. 2001;55(12):556-9. References Martins et al. Brugada pattern, Brugada phenocopy, what to think? Int J Cardiovasc Sci. 2019;32(1)91-94 Case Report 2. Resolution of the ECGC pattern once the underlying condition has been treated; 3. Low pretest probability for BrS established by lack of symptoms and no family history of BrS; 4. Negative provocative testingwith a sodium channel blocking agent; 5. Negative genetic testing Propafenone has many known side effects, including increase of PR interval, widening of the QRS complex, bundle branch block, ventricular arrhythmias, bradycardia and hypotension. However, there are few reports on the effects of an overdose of propafenone, which have speculated the mechanisms of calcium channel inactivation even in the absence of a genetic mutation. 7-11 “BrP” do not include type 1 Brugada pattern induced by calcium channel blockers and hence we could not find a correct classification of our case reported. If on one hand some authors suggest provocative testing for patients with a “non-type 1” Brugada pattern to provide lifestyle counseling on fever management and use of provocative drugs, on the other hand, some advocate that there is no gain in performing this test in asymptomatic, “non-type 1” Brugada pattern patients for risk stratification. Thus, the role of provocative tests in patients with type 1 Brugada pattern in intoxication by propafenone has not been established. In the case reported, we decided not to perform the provocative test; the adolescent is well, under no psychiatric treatment. 9 Conclusion Propafenone intoxication is a rare event and, to our knowledge, there is no detailed epidemiologic study on this in the literature. 8,11 Despite the severity of the condition, successful stabilization of the individual was achieved by early resuscitation, invasive mechanical ventilation, transitory stimulation, and correct management of acidosis. This case emphasizes the importance of distinguishing the toxicological effect of BS from that of BrP. Author contributions Conception and design of the research: Martins JL, Ferreira R. Acquisition of data: Martins JL. Analysis and interpretation of the data: Martins JL. Writing of the manuscript: Martins JL, Ferreira R. Critical revision of the manuscript for intellectual content: Martins JL, Ferreira R, Viana J, Santos J. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associated with any thesis or dissertation work.