Type 1 electrocardiographic burden is increased in symptomatic patients with Brugada syndrome.

BACKGROUND: Spontaneous type 1 electrocardiographic (ECG) is a risk factor for arrhythmic events in Brugada patients but the importance of the proportion of time with a type 1 ECG is unknown. PATIENTS AND METHODS: Thirty-four Brugada patients (15 symptomatic) underwent a 24-hour 12-lead ECG recording. One-minute averaged waveforms displaying ST-segment elevation above 200 microV, with descending ST-segment and negative T-wave polarity on leads V(1)-V(3) were considered as type 1 Brugada ECG. The burden was defined as the percentage of type 1 Brugada waveforms. RESULTS: Type 1 ECG on lead V2 was more frequent in symptomatic patients (median 80.6% [15.7-96.7] vs 12.4% [0.0-69.7], P = .05). Patients with a permanent type 1 pattern on lead V(2) were more likely to be symptomatic (5/6) than patients without type 1 ECG during a 24-hour period (2/9) (P < .05). CONCLUSION: Type 1 pattern is more prevalent across a 24-hour period in symptomatic Brugada patients.