Brugada syndrome without mutation of the cardiac sodium channel gene in a Taiwanese patient

We describe a 45-year-old Taiwanese man with specific features of Brugada s yndrome but no clinical features of structural heart disease. He was succes sfully, treated with an implantable cardioverter-defibrillator. His electro cardiogram (ECG) patterns changed intermittently. Alpha-adrenoceptor stimul ation and beta-adrenoceptor blockade augmented the characteristic ST-segmen t elevation, whereas alpha-adrenoceptor blockade and beta-adrenoceptor stim ulation mitigated the ST-segment elevation, intravenous procainamide admini stration did not aggravate ST-segment elevation when ECG had shown coved ST elevation in the right precordial leads. Molecular study did not reveal th e same mutations in the cardiac sodium channel gene (SCN5A) as previously r eported in Brugada syndrome. This case demonstrates the genetic heterogenei ty of SCN5A in Brugada syndrome.