Referenced in: none

Automatically associated channels: Nav1.5

Title: Brugada syndrome ECG provoked by the selective serotonin reuptake inhibitor fluvoxamine.

Authors: Guido Stirnimann, Séverine Petitprez, Hugues Abriel, Nicola G Schwick

Journal, date & volume: Europace, 2010 Feb , 12, 282-3

PubMed link: http://www.ncbi.nlm.nih.gov/pubmed/19875396

Abstract
A patient with an SCN5A p.W822X nonsense mutation, localized in the transmembrane region DII-S4 of the Na(v)1.5 sodium channel and leading to a non-expression of the mutant allele, was prescribed the selective serotonin reuptake inhibitor (SSRI) fluvoxamine (Floxyfral), 100 mg per day. His normal baseline ECG changed to a characteristic Brugada-Type-1-ECG pattern. To investigate whether fluvoxamine may reduce the cardiac sodium current, the effect of this drug was studied on the wild-type voltage-gated cardiac sodium channel Na(v)1.5 stably expressed in HEK293 cells. Patch-clamp recording showed a 50% inhibition of the current at a concentration of 57.3 microM. In our patient, no arrhythmia occurred but the proarrhythmic potential of SSRI in patients with SCN5A mutations cannot be excluded. Therefore, we advise 12-lead ECG control after administering SSRI in these patients.