Current electrocardiographic criteria for diagnosis of Brugada pattern: a consensus report

Luna, Antonio; Brugada, Josép; Baranchuk, Adrián; Borggrefe, Martin; Breithardt, G; Goldwasser, Diego; Lambiase, Pier D.; Riera, Andrés Pérez; García‐Niebla, Javier; Pastore, Carlos Alberto; Oreto, Giuseppe; McKenna, William J.; Zaręba, Wojciech; Brugada, Ramón; Brugada, Pedro

doi:10.1016/j.jelectrocard.2012.06.004

Cited by 331 publications

(247 citation statements)

References 50 publications

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“…The ECG obtained during ExT shows visible ST-segment elevations in precordial leads during rest and periods with ST morphology resembling type 1 BrS ECG pattern in V1 during early recovery phase (Brugada-like pattern) [5].…”

Section: Discussionmentioning

confidence: 96%

“…Current European Society of Cardiology (ESC) guidelines recommend diagnosis of BrS in the setting of ST-segment elevation ≥2 mm with type 1 BrS morphology in at least one lead (V1 and/ or V2) placed in the second, third or fourth intercostal space [4]. According to guidelines typical electrocardiographic (ECG) BrS pattern, with coved type ST-T configuration [5], may occur spontaneously or after intravenous administration of sodium channel blockers [4]. Several reports indicate, that BrS ECG pattern may be also revealed during physical exercise testing (ExT) [6,7].…”

Section: Introductionmentioning

confidence: 99%

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Exercise ECG unmasked Brugada sign: manifestation of the risk of sports-associated sudden cardiac arrest (RCD code: V-1A.1)

Matusik

Komar

Podolec

et al. 2017

Journal of Rare Cardiovascular Diseases

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Sports-associated sudden cardiac arrest (SCA) constitutes an important problem. Causes of SCA during sport activities include Brugada syndrome (BrS) among others. We describe a 29-year-old male, without a history of cardiovascular disease, who suffered from SCA during football training and despite intensive treatment, after almost 4 weeks of hospitalization, unfortunately died. Detailed medical documentation review showed grade I atrioventricular block, intraventricular conduction abnormalities and BrS type 2 morphology of ST-segment elevation on resting 12-lead electrocardiogram (ECG). The patient had a history of syncope during physical activity. Further echocardiographic study did not reveal significant structural heart disease. Submaximal exercise testing was performed and showed ventricular extrasystoles during physical activity and type 1 BrS morphology of ST-segment elevation during recovery phase. We compared observed ECG changes to those present in a healthy football player and described noticeable similarities. Exercise ECG testing, especially in patients after syncope of probable arrhythmic etiology, may unmask BrS ECG pattern and lead to BrS diagnosis. JRCD 2017; 3 (3): 92-97

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Exercise ECG unmasked Brugada sign: manifestation of the risk of sports-associated sudden cardiac arrest (RCD code: V-1A.1)

Matusik

Komar

Podolec

et al. 2017

Journal of Rare Cardiovascular Diseases

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“…However, in athletes younger than 16 years old and black athletes the combination of early repolarization and inverted T-waves in precordial leads can be normal variants (17). The differential diagnosis between Brugada-like pattern and athletic normal variant early repolarization is still challenging, but some new ECG criteria were established recently (1,20). In our study, ST segment changes, mainly horizontal ST depression in inferolateral leads were also found more often in athletes compared to controls, whereas no underlying structural heart disease or chanellopathy could be diagnosed.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of physiological and pathological electrocardiographic findings in Hungarian athletes

Kiss

Sydó

Vargha

et al. 2015

Acta Physiologica Hungarica

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In Hungary, ECG is a keystone of routine athletic screening. Its significance is based on simplicity, quickness and high informative value as well as the fact that appearance of pathological ECG signs can precede the formation of structural heart diseases. During screening of healthy athletes, we studied the incidence of athletic ECG changes and pathological ECG abnormalities. Methods: We performed detailed analysis of 12-lead ECG recordings of asymptomatic elite, non-elite and master athletes and controls. Results: 227 athletes (male: 180, age: 27.2±8.7 years) and 89 controls (male: 57, age: 28.1±6.8 years) were examined. Benign ECG signs: sinus bradycardia, early repolarization and isolated Voltage criteria of left ventricular hypertrophy were common and more often in athletes compared to controls. Potentially pathological ECG signs: ST-(6.6% vs. 1.1%, p < 0.05) and T-wave (15.0% vs. 5.6%, p < 0.05) changes and signs of pathological left ventricular hypertrophy (5.3% vs. 0%, p < 0.05) occurred more frequently in athletes compared to controls. Conclusions: Signs of pathological left ventricular hypertrophy and repolarization abnormalities are more often in athletes. No structural heart disease could be verified in the background of the disorders. However, athletes having pathological ECG should be kept under tight cardiology control. Exact definition and widespread knowledge of pathological ECG changes is essential in early recognition of high risk athletes.

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“…Although all three patterns can be present in BrS and even in the same patient at different times, only type 1 ECG is considered diagnostic of the syndrome. [17][18][19][20] In fact, according to the last expert consensus document on inherited primary arrhythmia syndromes, BrS is definitively diagnosed when a type 1 ST-segment elevation is observed either spontaneously or after intravenous administration of a sodium channel blocking agent in at least one right precordial lead (V1 and V2), placed in a standard or a superior position (up to the second intercostal space). 6 Moreover, in 2012 a group of experts produced a consensus document on ECG criteria outlining a number of new features that can help to identify the Brugada type 1 ECG.…”

Section: Brugada Syndrome and Early Repolarisationmentioning

confidence: 99%

Brugada Syndrome and Early Repolarisation: Distinct Clinical Entities or Different Phenotypes of the Same Genetic Disease?

Conte

Caputo

Regoli

et al. 2016

Arrhythmia &Amp; Electrophysiology Review

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General understanding of early repolarisation (ER) has dramatically changed in the last decade. For several years, ER has been considered a benign electrocardiographic (ECG) finding with high prevalence in the general population. Recently different studies have challenged this view and showed a significant association with life-threatening arrhythmias. [1][2][3][4][5] In 2008 Haïssaguerre et al. first reported an increased prevalence of a particular pattern of ER on the resting 12-lead ECG of patients with history of idiopathic ventricular fibrillation (VF) (see Figure 1). 2 In these patients, ER was characterised by elevation of the QRS-ST segment junction of at least 0.1 mV above the baseline level, manifesting as QRS slurring (a smooth transition from the QRS complex to the ST segment) or notching (a positive J deflection of at least 1 mm inscribed on the S wave) in two adjacent inferior (II, III and aVF), lateral (I, aVL, and V4-V6), or infero-lateral leads. The ER pattern was observed in 31 % of patients with idiopathic VF and in 5 % of healthy control subjects.Moreover, patients with idiopathic VF and ER pattern presented a higher risk of experiencing an arrhythmic recurrence during a 5-year follow-up.2 This observation was confirmed by a case-control study showing that J-point elevation in the inferior and lateral leads is more frequent in patients with idiopathic VF than in matched control subjects (27 % versus 8 % in inferior leads; 13 % versus 1 % in lateral leads).3 Conversely, ER localised exclusively in V4 to V6 occurs with similar frequency among patients and healthy subjects.

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Current electrocardiographic criteria for diagnosis of Brugada pattern: a consensus report

Cited by 331 publications

References 50 publications

Exercise ECG unmasked Brugada sign: manifestation of the risk of sports-associated sudden cardiac arrest (RCD code: V-1A.1)

Exercise ECG unmasked Brugada sign: manifestation of the risk of sports-associated sudden cardiac arrest (RCD code: V-1A.1)

Prevalence of physiological and pathological electrocardiographic findings in Hungarian athletes

Brugada Syndrome and Early Repolarisation: Distinct Clinical Entities or Different Phenotypes of the Same Genetic Disease?

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