Clinical and Electrocardiographic Characteristics of Patients with Brugada Syndrome: Report of Five Cases of Documented Ventricular Fibrillation

Abstract

Background: Brugada syndrome is a disease in which idiopathic ventricular fibrillation (VF) sometimes occurs and causes sudden death. However, the clinical characteristics are still not fully understood.Patients and Methods: Five patients with Brugada syndrome, and with spontaneous VF documented by electrocardiograms (ECGs), were included in this study. We examined their clinical and electrocardiographic characteristics.Results: The mean age at the first VF/syncope episode was 54:4 ± 11:4 years. The mean follow‐up duration of the study was 114:8 ± 35:9 months. In 4 patients, typical coved‐type ST‐elevation with a circadian change in >1 right precordial lead (V1 to V3) was observed, and in the remaining patient it developed only after a pilsicainide test. VF was initiated by ventricular premature contractions (VPCs), which were almost identical to the preceding VPCs. While the isolated VPCs rarely occurred before VF in the patients whose late potentials were positive, in the patient whose late potential was negative, there were frequent episodes of VPCs before VF.Conclusion: In this study, we presented variable clinical and electrocardiographic characteristics of the patients. The differences might suggest that several mechanisms are involved in the onset of VF in Brugada syndrome.