Chronic Kratom Use Unmasks Type 1 Brugada Pattern in 52-Year-Old Man

Why it matters

This case adds to growing evidence that kratom can unmask or induce Brugada pattern on EKG — a potentially life-threatening cardiac condition — and suggests kratom use should be screened in patients presenting with unexplained arrhythmias.

The big picture

As kratom use grows among Americans seeking alternatives to opioids for pain management, this case highlights that kratom's cardiac effects are not limited to overdose scenarios; even chronic therapeutic use may trigger serious electrophysiological changes.

Key findings

• • A 52-year-old male with 1 year of kratom use for arthritis pain presented with sudden dizziness and EKG showing Type 1 Brugada pattern
• • His EKG normalized 2 days after presentation without other identified triggers
• • Electrophysiological study showed no inducible ventricular arrhythmias; a loop recorder was implanted
• • No family history of sudden cardiac death; kratom was identified as the most likely trigger

What they say

Case report presented at ACC.22, Rochester Regional Health/Unity Hospital; published in JACC Volume 79, Issue 9, 2022.

Bottom line

Chronic kratom use for pain management can trigger Type 1 Brugada pattern EKG changes that resolve with cessation — patients using kratom should be counseled about cardiac risks.