ST Segment Elevation on Electrocardiogram: The Electrocardiographic Pattern of Brugada Syndrome

Ali A. Sovari, MD; Marilyn A. Prasun, RN, PhD; Abraham G. Kocheril, MD, FAC C, FACP

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Brugada Syndrome

Brugada and Brugada first described the eponymous syndrome as a distinct clinical and electrocardiographic presentation with pseudo right bundle branch block (RBBB), ST segment elevation in the right precordial ECG leads and association with sudden cardiac death.[1] It later became clear that widening of the QRS and presence of RBBB are usual but not necessary features of the anomaly.[2] The prevalence and incidence of this syndrome in the United States is not known, but it is common in south Asia and Japan. Brugada syndrome usually presents with syncope and is frequently associated with arrhythmias such as atrial fibrillation, supraventricular tachycardia, polymorphic ventricular tachycardia (VT), and ventricular fibrillation (VF). It is the most common cause of sudden cardiac death (SCD) in patients with a structurally normal heart. It is more common in males than females and typically first presents in the third decade of life, although it has been reported in children and the elderly too.

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