We describe a patient with Brugada syndrome. The ST-segment elevation in pr
ecordial leads was revealed during admission, but the appearance of J waves
was characteristic before ventricular fibrillation (VF), rather than ST-se
gment elevation. J waves have been reported to be associated with the prese
nce of an Ito-mediated prominent action potential notch in the epicardium.
It is considered that one of the mechanisms of this VF is due to heterogene
ous distribution of the refractory period according to changes in K+ channe
ls including Ito.