{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:47:06Z","timestamp":1762004826751,"version":"3.40.4"},"reference-count":17,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,6,16]]},"abstract":"<jats:p>Brugada syndrome is an inherited arrhythmogenic disease, characterised by a coved-type ST segment elevation in right precordial leads and an increased risk of sudden cardiac death due to ventricular arrhythmia. To unmask or exacerbate a Brugada ECG pattern, class IA or IC antiarrhythmic agents are used, and clinicians can predict sudden cardiac death in a high-risk patient. However, phenytoin, one of the class IB agents, may induce a Brugada pattern ECG at a supra-therapeutic level and this association has rarely been reported. We describe a case of a patient with a phenytoin level about twice as high as the therapeutic level, which led to the emergence of a type 1 Brugada pattern ECG. Awareness should be made between this important association of supra-therapeutic phenytoin level and type 1 Brugada pattern ECG because symptomatic Brugada syndrome can lead to sudden cardiac death.<\/jats:p>","DOI":"10.1136\/bcr-2016-214899","type":"journal-article","created":{"date-parts":[[2016,6,29]],"date-time":"2016-06-29T15:00:20Z","timestamp":1467212420000},"page":"bcr2016214899","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Type 1 Brugada pattern ECG due to supra-therapeutic phenytoin level"],"prefix":"10.1136","volume":"2016","author":[{"given":"Thein","family":"Swe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bikash","family":"Bhattarai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alix","family":"Dufresne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,6,28]]},"reference":[{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.1","DOI":"10.1016\/0735-1097(92)90253-J"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.2","DOI":"10.1161\/01.CIR.0000034169.45752.4A"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.3","DOI":"10.1161\/01.CIR.0000152479.54298.51"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.4","DOI":"10.1161\/01.CIR.101.5.510"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.5","DOI":"10.1146\/annurev.me.25.020174.000531"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.6","DOI":"10.1001\/archinte.158.4.325"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.7","DOI":"10.1016\/j.cpcardiol.2004.04.005"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.8","DOI":"10.1016\/0735-1097(95)00613-3"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.9","DOI":"10.1111\/j.1540-8159.2007.00734.x"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.10","DOI":"10.1161\/CIRCULATIONAHA.104.485326"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.11","DOI":"10.1161\/01.CIR.0000153267.21278.8D"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.12","DOI":"10.1161\/01.CIR.102.20.2509"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.13","DOI":"10.1016\/S1474-4422(06)70350-7"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.14","DOI":"10.1053\/euhj.1998.1332"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.15","DOI":"10.1016\/j.eplepsyres.2013.02.024"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.16","DOI":"10.1212\/01.WNL.0000052997.43492.E0"},{"doi-asserted-by":"publisher","key":"2025042703392969000_2016.jun28_1.bcr2016214899.17","DOI":"10.4103\/0972-5229.40946"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-214899","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T10:39:37Z","timestamp":1745750377000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-214899"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6,28]]},"references-count":17,"alternative-id":["10.1136\/bcr-2016-214899"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-214899","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2016,6,28]]}}}