Letters Regarding Article by Coronel et al, “Right Ventricular Fibrosis and Conduction Delay in a Patient With Clinical Signs of Brugada Syndrome: A Combined Electrophysiological, Genetic, Histopathologic, and Computational Study”

Abstract

To the Editor: We read with interest the report by Coronel et al1 of a case of Brugada syndrome with structural abnormalities of the heart. We would like to comment on the ECG presentation of the patient, which, in our opinion, raises an important interpretation issue. According to the criteria proposed by a group of experts that included 2 authors of the aforementioned report,2 the ECG of the patient reported in the article by Coronel et al1 does not appear to be diagnostic for Brugada syndrome. In fact, the Second Consensus Conference2 states that only “type 1 is diagnostic of Brugada syndrome and is characterized by a coved ST-segment elevation ≥2 mm, followed by a negative T wave, observed in >1 right precordial lead.” In the tracings of the patient presented by Coronel and colleagues,1 the ST-segment elevation is present only in lead V1, does not show a coved morphology in >1 lead, and has no negative T wave. As the authors discuss in the article,1 the presence of a mutation in the SCN5A gene is …