Two year follow-up of individuals with the automatic ecg detection of brugada type

BACKGROUND: Coved and saddleback patterns of ST segment elevation with right bundle branch block were recognized as the Brugada syndrome corresponding with a sudden cardiac death, but the shape of ECG was fluctuated on the time course independently of it's significance. We have reported a program of the automatic detection of RBBB with ST segment elevation in leads V(1) to V(3), and have examined 33 patients from our database on the filing system about 2 year follow-up. Methods and Results: In 2000, 6 women and 27 men (mean age: 60 +/- 15 yrs) were sampled by the program with two cardiologists from 36,248 cases as follows: Coved type: ST(j) > ST(1) > ST(2), ST(1) > 0.2mV, T < ST(jx) 1.5, S < 0.3mV in V(1-2). Saddleback type: with RBBB, ST(1) > 0.2mV, T < ST(jx)1.5, S < 0.3mV in V(1). ST(j), ST(1) and ST(2) are amplitude of ST segment (ST(j): J point, ST(1): J + QT/10, ST(2): J + 2 x QT/10). Acute myocardial infarction and QT prolongation were excluded. The incidence of Brugada-type was 0.09% (19 Coved, 11 saddleback and 3 intermediate type), but there was no patient with typical Brugada syndrome in our sampling in 2000. The clinical characteristics were recognized with syncope in 3, family history of sudden death in 2, ischemic heart disease in 6 and no cardiac disease in 22. The patient with family history and coved type was died due to pneumonia in 2002. ECGs were fluctuated with no relation of the recording time among individuals. CONCLUSIONS: Compared with the previous reports, the same incident rate was analyzed by this program and filing system. It was invaluable to detect the Brugada-type as a screening. Because the only Brugada-type ECG was detected it does not necessarily follow that it will be in danger, but it had better to examine carefully with the history taking including syncope, family history and further examinations.