Brugada Phenocopies: Consideration of Morphologic Criteria and Early Findings From an International Registry

Abstract

Brugada syndrome (BrS) is an inherited sudden cardiac death syndrome characterized by type 1 or type 2 electrocardiographic (ECG) patterns in precordial leads V1-V3 that predispose individuals to malignant ventricular arrhythmias and sudden cardiac death. Brugada phenocopies (BrPs) are clinical entities that have ECG patterns that are identical to true congenital BrS but are elicited by various other clinical or technical factors such as myocardial ischemia, metabolic abnormalities, mechanical mediastinal compression, or poor electrocardiographic (ECG) filters. This article discusses the conceptual emergence of BrP as a new ECG phenomenon, reviews the current BrP diagnostic criteria, and provides a new morphologic classification that more precisely categorizes future BrP cases. Preliminary results from the International Registry of Brugada Phenocopies (www.brugadaphenocopy.com) are also discussed.