What is the Prevalence, Incidence and Prognostic Value of Brugada-type Electrocardiogram in the General Population?

Abstract

Patients who have no structural heart disease but whose ECGs are characterized by unique changes in the ST segment elevation on leads V1–V3, with or without a right bundle branch block (RBBB) pattern, occasionally develop ventricular fibrillation (VF). Such patients are recognized as having Brugada syndrome and are at high risk for sudden cardiac death. Although more than 10 years have passed since the first report by Brugada and Brugada [1], there is still no pharmacological treatment that can reliably prevent VF. Therefore, patients who have a Brugada-type ECG pattern (ST elevation in VI–V3 with or without RBBB; “Brugada-type ECG patterns”) and have experienced an episode of syncope and/or aborted sudden cardiac death are strongly advised to receive an implantable cardioverter-defibrillator (ICD). On the other hand, there are substantial numbers of individuals who exhibit the Brugada-type ECG patterns without clinical symptoms, arrhythmia, or a family history of sudden cardiac death. These individuals may be found on ECG examinations performed at health check-ups or for other medical reasons than monitoring for cardiac diseases. Therefore, an emphasis has been put on individuals who exhibit ECG patterns compatible with the Brugada syndrome while showing no clinical symptoms or family history of sudden cardiac death. However, the prognosis of these asymptomatic individuals with Brugada-type ECG patterns has not been clarified.