Prevalence of Brugada- Pattern in an Unselected Urban Population

Abstract

To determine the prevalence of Brugada-pattern in an unselected urban population served by a tertiary medical center. We reviewed the ECG database at the Montefiore Medical Center, a tertiary teaching center in the Bronx, New York, USA, over a ten-year period from 1994-2004. During this time period over 653,006 ECG records in 162,590 patients were identified. The database was queried applying standard diagnostic criteria in an attempt to search records with apparent conduction delay and ST abnormality in leads V1-V3 (i.e. RBBB, IRBBB, RSR' in V1). Additional diagnostic criteria were applied in an attempt to mimic Brugada-like changes. A cardiac electrophysiologist, to confirm the presence of a Brugada-type pattern, reviewed records meeting these criteria. 16,067 patients (9.8%) were identified as having ECG's with right bundle branch block, incomplete right bundle branch block, or RSR in lead V-1. Applying the additional diagnostic criteria evaluating ST segment shift, 456 patients were identified as having a pattern potentially consistent with a Brugada-type ECG. Upon physician's review the presence of a Brugada-type pattern was confirmed in 20 patients (0.012%). The Brugada-type ECG pattern is infrequently seen in an unselected inner city US population. Further evaluation should be considered when this pattern is seen on routine ECG.