Brugada-type electrocardiographic pattern induced by cocaine

Right bundle branch block with coved ST-segment elevation in leads V-1 thro ugh V-3 is the electrocardiographic (ECG) marker of the Brugada syndrome. W e describe a healthy young man with a normal baseline ECG in whom a transie nt Brugada pattern was observed repeatedly after recreational cocaine use. Intravenous administration of procainamide and subsequent intravenous propr anolol followed by noradrenaline failed to reproduce the Brugada sign, An e lectrophysiologic study performed in the presence of the Brugada ECG patter n showed no inducible arrhythmias, This case illustrates that, in susceptib le individuals, cocaine may provoke the Brugada sign. The clinical importan ce of this cocaine-induced ECG abnormality is currently unknown.