Brugada like ECG strip

Brugada like ECG strip

This three lead strip of an ECG shows rSr’ pattern in V1 and V2 with ST elevation. ST elevation in V2 has a ‘saddle back’ pattern. T wave is inverted in V1 and V2 while it is upright in V3. Such patterns should make one consider the possibility of Brugada syndrome, though similar patterns can also occur in early repolarization syndrome. A history of syncope or a positive family history of sudden cardiac death would favor the diagnosis of Brugada syndrome in such cases.

Genetic testing may not be useful because genetic abnormalities have been documented in only about one fifth of clinical cases of Brugada syndrome. Brugada like ECG often causes a dilemma to the clinician as there is a potential for life threatening arrhythmias in Brugada syndrome while a large majority of persons with such ECG patterns never have any symptoms.