Prevalence of the Brugada electrocardiographic pattern at the Medical Center of Louisiana in New Orleans.

ABSTRACT

Since 1992 the Brugada syndrome has gained recognition as a cause of ventricular fibrillation. The syndrome was originally described in patients with the diagnostic triad of (1) right bundle branch block, (2) an electrocardiogram (ECG) with persistent ST-segment elevation in leads V1, V2, and V3, and (3) sudden cardiac death. Two different types of ST-segment elevation, coved and saddleback, have been described. All patients originally described had structurally normal hearts. The definition of the Brugada electrocardiogram (originally right bundle branch block and ST-segment elevation in V1, V2, and V3 in characteristic coved or saddleback configuration) has been evolving since the initial description, and not all patients with the Brugada electrocardiogram have the Brugada syndrome. We designed a trial to determine the prevalence in our population at the Medical Center of Louisiana in New Orleans of the Brugada ECG as it was originally defined. ECGs performed in 1997 were examined for changes consistent with the Brugada electrocardiogram. Those ECGs with changes secondary to another identifiable cause were excluded. The amount and type of ST-segment elevation in leads V1, V2, and V3 were recorded for the remaining ECGs. From a total of 55,446 electrocardiograms performed on 27,328 patients, we were able to identify only 18 ECGs with the changes originally described by Brugada, and none of them meet current criteria. Our study suggests that in our patient population the ECG now considered typical of the Brugada syndrome is rare.