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:
- Type I: Coved ST elevation >=2mm in V1-V3 followed by a negative T wave.
- Type II: Saddleback ST elevation.
- 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.