Typical ECG features of Brugada syndrome fluctuate and might only manifest in the presence of fever, drugs, or tachycardia. ECG patterns are also known to change with time and age.

Performing a 12-lead ECG with the precordial leads (V1 and V2) higher up in the second or third intercostal space or using bipolar chest leads are techniques known to accentuate these abnormalities and should be performed when there is doubt about the diagnosis.

The diagnosis of Brugada syndrome is only established if the patients’ ECG converts to a Type 1 ECG pattern (if originally Type 2) upon provocation by drugs.

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