{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:10:30Z","timestamp":1789729830605,"version":"4.0.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Brugada syndrome is a genetic disorder associated with sudden cardiac death (SCD) due to ventricular fibrillation (VF). The diagnosis relies on detecting a Type 1 ST-segment elevation in the right precordial leads, which often requires sodium channel blocker provocation for confirmation. Patient concerns: We present a case of a 55-year-old male bus driver who experienced out-of-hospital cardiac arrest due to VF. Diagnosis: After resuscitation, initial evaluations, including echocardiography and cardiac enzyme tests, were normal, showing no structural heart disease. The initial electrocardiogram displayed a Type 2 Brugada pattern. Intervention: A flecainide challenge test using oral flecainide (300\u00a0mg) revealed a Type 1 Brugada pattern, confirming Brugada syndrome. Outcomes: Despite mild hypokalemia, an implantable cardioverter defibrillator (ICD) was implanted due to the patient\u2019s high-risk occupation and VF history. Conclusion: This case underscores the importance of considering Brugada syndrome in unexplained VF cases and highlights the role of flecainide testing in diagnosis. A multidisciplinary approach, including thorough evaluation, timely ICD implantation, and patient education, is crucial for optimal outcomes, particularly for those in safety-critical professions. Recognizing Brugada syndrome and applying appropriate diagnostic and therapeutic measures are essential for preventing fatal arrhythmic events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1093\/omcr\/omaf301","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T12:57:51Z","timestamp":1766062671000},"source":"Crossref","is-referenced-by-count":1,"title":["Diagnosis and management of Brugada Syndrome Unmasked by Flecainide challenge in a patient with unexplained ventricular fibrillation: a case report"],"prefix":"10.1093","volume":"2026","author":[{"given":"Hyeon Jeong","family":"Oh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital , Goyang ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyu-Yong","family":"Ko","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital , Goyang ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7242-5217","authenticated-orcid":false,"given":"Sung Eun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital , Goyang ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Woo","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital , Goyang ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Jin","family":"Kwak","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital , Goyang ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4668-8229","authenticated-orcid":false,"given":"Ji-Won","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital , Goyang ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"2026012811460254200_ref1","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1161\/01.CIR.0000152479.54298.51","article-title":"Brugada syndrome: report of the second consensus conference: endorsed by the Heart Rhythm Society and the European heart rhythm association","volume":"111","author":"Antzelevitch","year":"2005","journal-title":"Circulation."},{"key":"2026012811460254200_ref2","doi-asserted-by":"publisher","first-page":"e272","DOI":"10.1161\/CIR.0000000000000614","article-title":"2017 AHA\/ACC\/HRS guideline for Management of Patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology\/American Heart Association task force on clinical practice guidelines and the Heart Rhythm Society","volume":"138","author":"Al-Khatib","year":"2018","journal-title":"Circulation."},{"key":"2026012811460254200_ref3","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1161\/01.CIR.101.5.510","article-title":"Sodium channel blockers identify risk for sudden death in patients with ST-segment elevation and right bundle branch block but structurally normal hearts","volume":"101","author":"Brugada","year":"2000","journal-title":"Circulation."},{"key":"2026012811460254200_ref4","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.ijcard.2007.07.159","article-title":"Prevalence and significance of Brugada-type ECG in 12,012 apparently healthy European subjects","volume":"130","author":"Gallagher","year":"2008","journal-title":"Int J Cardiol"},{"key":"2026012811460254200_ref5","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.1016\/j.jacc.2010.06.033","article-title":"Augmented ST-segment elevation during recovery from exercise predicts cardiac events in patients with Brugada syndrome","volume":"56","author":"Makimoto","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2026012811460254200_ref6","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.ipej.2016.06.001","article-title":"Flecainide challenge test: predictors of unmasking of type 1 Brugada ECG pattern among those with non-type 1 Brugada ECG pattern","volume":"16","author":"Prasad","year":"2016","journal-title":"Indian Pacing Electrophysiol J"},{"key":"2026012811460254200_ref7","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.joa.2016.07.002","article-title":"J-wave syndromes expert consensus conference report: emerging concepts and gaps in knowledge","volume":"32","author":"Antzelevitch","year":"2016","journal-title":"J Arrhythm"},{"key":"2026012811460254200_ref8","doi-asserted-by":"publisher","first-page":"1442","DOI":"10.1016\/j.hrthm.2017.06.031","article-title":"Sodium-channel blocker challenge in the familial screening of Brugada syndrome: safety and predictors of positivity","volume":"14","author":"Therasse","year":"2017","journal-title":"Heart Rhythm"},{"key":"2026012811460254200_ref9","doi-asserted-by":"publisher","first-page":"B41","DOI":"10.1016\/0002-9149(84)90501-0","article-title":"Metabolism of flecainide","volume":"53","author":"Conard","year":"1984","journal-title":"Am J Cardiol"},{"key":"2026012811460254200_ref10","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1161\/CIRCULATIONAHA.104.485326","article-title":"Should patients with an asymptomatic Brugada electrocardiogram undergo pharmacological and electrophysiological testing?","volume":"112","author":"Brugada","year":"2005","journal-title":"Circulation."}],"container-title":["Oxford Medical Case 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