Ventricular flutter triggered by fever in a patient with Brugada syndrome

Brugada syndrome is a clinical-electrocardiographic entity predisposing to malignant ventricular arrhythmias. The typical arrhythmia is polymorphic ventricular tachycardia, which can potentially degenerate to ventricular fibrillation. Monomorphic ventricular tachycardia is uncommon. Our group is reporting the case of a 39-year-old man with known Brugada syndrome who developed ventricular flutter while febrile. Fever has previously been shown to unmask Brugada changes and to induce ventricular arrhythmias. The appearance of monomorphic ventricular tachycardia potentially attributable to sodium-channel dysfunction further confounds the mechanism of arrhythmogenesis in Brugada syndrome. This curious occurrence further underlines the likely complex nature of arrhythmogenesis in Brugada syndrome.