Brugada ECG Morphology

Fig.1 via LITFL

If Type 1 ECG morphology is demonstrated, there is no need for drug testing. However, this is not the case in Types 2 and 3 where sodium channel blockers are used to confirm the diagnosis.

In view of the potentially catastrophic nature of this disease, inpatient referral is mandatory if Brugada syndrome is suspected to be the cause of ST elevation.

Learning bite

Consider Brugada syndrome in anyone with downward sloping ST segment elevation in the right precordial chest leads.

Be cautious of ruling out Brugada syndrome in someone who gives you a good history just because they do not have the characteristic Type 1 ECG changes. Remember the use of drug testing.

The image illustrates the ECG characteristics of Brugada syndrome types (click on the ECG to enlarge).