Ventricular Tachycardia or Conduction Disease: What Is the Mechanism of Death in Brugada Syndrome?
A distinct electrocardiographic (ECG) pattern of right bundle branch block with ST-segment elevation in V1-V2-V3 was first described in 1989 in patients who suddenly died affected by subclinical right ventricular cardiomyopathy . In the late 1990s, Brugada et al.  reported on eight patients with the same ECG configuration and sudden death and suffested that this new clinical entity was secondary to a primary “functional” disorder but not a structural abnormality. They advanced the hypothesis that “marked dispersion refractoriness of cardiac tissue or extreme anisotropic conduction properties of the conduction system and the venticular muscle” was the underlying photophysiologic substrate of the syndrome. The findings of right bundle branch block, ST-segment elevation, and sudden death were then recognized in different clinical entities, both structural and functional (Table 1) .
KeywordsBrugada Syndrome Right Bundle Branch Block Ventricular Cardiomyopathy Cardiac Conduction Defect Unipolar Electrogram
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