Key result
Vigorous exercise attenuates Brugada repolarisation anomalies during peak exertion but worsens them immediately post-exercise.
Case Report (n=1)
Demonstrates that diagnostic Brugada repolarisation anomalies can be attenuated during vigorous exertion and exaggerated immediately after, highlighting autonomic influences on the phenotype.
Post-exercise ECG accentuation may aid Brugada detection in athletes; leaves open autonomic effects on phenotyping and risk stratification.
A 30-year-old male athlete with exercise-related syncopal symptoms spontaneously exhibited a type 1 Brugada ECG and was inducible during electrophysiology study. He was diagnosed with symptomatic Brugada syndrome and deemed at high risk of sudden cardiac death. Thus, he received a cardioverter/defibrillator and was advised to abstain from further competitive sports activities. This case points to a role of the ECG in pre-participation screening. It also demonstrates that, in athletes with Brugada syndrome, repolarisation anomalies may be markedly attenuated during vigorous exercise and considerably increased immediately after exercise. The observed J-wave amplitude dynamics suggests enhancement of pre-existing autonomic dysfunction through heavy exertion.
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Esperer et al. (2006) conducted a case report in Brugada syndrome (n=1). Vigorous exercise was evaluated on J-wave amplitude dynamics and ECG repolarisation anomalies. In a 30-year-old athlete with Brugada syndrome, repolarisation anomalies were attenuated during vigorous exercise and increased significantly immediately after exercise.
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