Two-year case collection of the Brugada syndrome electrocardiogram patternat a large teaching hospital

Background: Recommendations have recently emerged suggesting that the prese nce of the Brugada electrocardiographic (ECG) pattern in an otherwise asymp tomatic individual warrants electrophysiologic testing for inducible ventri cular arrhythmias. However, the prevalence of this pattern in the general p opulation and its specificity for identifying those likely to develop the t rue Brugada syndrome are not known. Hypothesis: The purpose of this study was to collect ECGs that displayed th e Brugada pattern from unselected, noncardiac patients at a single institut ion to determine whether the implied prevalence in the literature may repre sent a significant underestimation of the true prevalence. Methods: We performed a prospective case collection of Brugada-patterned EC Gs over a 2-year time period from unselected, noncardiac patients at a larg e urban teaching hospital. Results: Of approximately 12,000 noncardiac patients, 52 were found to have an ECG pattern fully consistent with the Brugada si,on. Conclusions: The Brugada type ECG pattern is much more prevalent than previ ously reported when rigorously searched for in a prospective manner. More d ata are needed on its specificity for predicting future arrhythmic events i n asymptomatic individuals before recommendations are made for extensive ev aluation in this group.