A 64-year-old female with paroxysmal atrial fibrillation presented to the emergency department with atrial fibrillation and rapid ventricular rate (Figure 1A), which was refractory to her usual combination doses of ‘pill-in-pocket’ metoprolol (25 mg) and flecainide (100 mg). She had a structurally normal heart on recent transthoracic echocardiogram. Upon questioning, the patient received a staggered 600 mg of flecainide in total orally due to a misunderstanding regarding her usual dosing. An electrocardiogram (ECG) obtained at this time revealed widening of the QRS and STdoming in leads V1 and V2, in keeping with a characteristic Type 1 Brugada pattern (Figure 1B). These ECG changes spontaneously resolved within 24 h and sinus rhythm was restored. The patient was reviewed by our local electrophysiologist. There were no features in keeping with high risk Brugada syndrome. Counselling was provided to the patient with regards to avoiding QT prolonging medications, treating pyrexia aggressively, and discontinuing flecainide.