Brugada syndrome

Brugada syndrome is an inherited condition associated with sudden cardiac death. It is autosomal dominant and most often affects the sodium channels, though other mutations have been found.

There are 3 ECG patterns associated with Brugada syndrome:

  1. Type I: Coved ST elevation >=2mm in V1-V3 followed by a negative T wave.
  2. Type II: Saddleback ST elevation.
  3. Type III: Saddleback or coved ST elevation <2 mm.

These ECG changes can be transient, e.g. appearing with fever, ischemia, medications, alcohol, hypothermia and hypokalemia. For diagnosis, type I changes must be present as well as a history of VF, VT (spontaneous or induced), syncope, nocturnal agonal breathing, or a family history of sudden cardiac death younger than 45 years old or similar coved ECG changes. Type 2 and 3 changes may warrant further investigation.

Treatment includes ICD insertion.

Featured Example