A 35-year-old man, working in the maintenance of electrical installations, went to the company medical service for a routine check-up. He was asymptomatic. He had been a smoker of 10 cigarettes/day for 8 years. He was not a consumer of alcoholic beverages, had no toxic habits and did not regularly take any medication. He had no family history of sudden death and had no personal history of syncope, lipothymia, convulsions, agonal nocturnal breathing or palpitations. The medical examination revealed no abnormalities in the physical examination or in the routine complementary examinations, with the exception of his baseline ECG.

Suspecting Brugada syndrome, he was referred to the Arrhythmia Unit of Hospital Clínic de Barcelona. After clinical and electrocardiographic assessment and a flecainide test, a diagnosis of BS was made. To complete the risk stratification, an electrophysiological study was also performed, which showed A-H intervals of 128 msec and HV of 44 msec. A ventricular pacing protocol was performed, without induction of sustained ventricular arrhythmias, and therefore, in conjunction with the patient's clinical data, it was concluded that BS was of low arrhythmic risk. Avoidance of the drugs and medications listed in Table 1 and vigorous treatment of any febrile symptoms were recommended, as it has been shown that fever can trigger ventricular arrhythmias in patients with BS6, and a genetic study was also scheduled. Six months later, the patient remains asymptomatic.