ECG Case 112: Brugada Syndrome

ECG Interpretation

  • Sinus rhythm, rate 70/min
  • Normal PR interval and QRS complex duration
  • Normal axis
  • QRS complexes in leads V1–V2 show an RSR1 pattern
  • ST segments elevated, and downward-sloping, in leads V1–V2

Brugada Syndrome Type 1

Clinical Interpretation

This is not a normal ECG. The appearances in leads V1–V2 are characteristic of the Brugada syndrome.

Brugada Syndrome Type 1 - Coved type ST segment elevation
Brugada Syndrome Type 1 – Coved type ST segment elevation
Types of Brugada Syndrome
Types of Brugada Syndrome

What to do ?

The Brugada syndrome involves a genetic abnormality that alters sodium transport in the myocardium, and predisposes to ventricular tachycardia and fibrillation. This patient’s collapse may well have been due to an arrhythmia.

The syndrome is often familial. The ECG changes are not constant, and on the day after admission this patient’s ECG was perfectly normal.

The ECG changes can be induced, and ventricular tachycardia caused, by antiarrhythmic drugs. The only treatment is an implanted defibrillator.