Key result
A case of Brugada syndrome demonstrated a global epicardial J wave with unipolar recording in both ventricles, suggesting masked early repolarization syndrome type 3.
Why the study?
Inferolateral early repolarization pattern increases ventricular fibrillation risk but can be masked by myocardial conduction delay or bundle branch block.
Case Report (n=1)
Highlights that inferolateral early repolarization patterns can be masked by conduction delays in Brugada syndrome but can be identified using epicardial unipolar recordings.
Case report of masked inferolateral ERP in BrS highlights diagnostic pitfalls; leaves open whether ERP independently predicts VF risk.
Brugada syndrome (BrS) is characterized by right precordial J-ST segment elevation on electrocardiogram (ECG) and increased risk of sudden cardiac death from ventricular fibrillation (VF).1 Several reports have suggested that the early repolarization pattern (ERP) in the inferolateral leads on ECG is a major risk for VF.2-4 However, inferolateral ERP can be masked by myocardial conduction delay and/or bundle branch block in a remote region.5,6 Although BrS and early repolarization syndrome (ERS) differ with regard to ECG lead location of ERP, they are considered to represent a continuous spectrum of phenotypes and Antzelevitch et al.
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Shako et al. (2023) conducted a case report in Brugada syndrome (n=1). Unipolar recording in both ventricles was evaluated. A case of Brugada syndrome demonstrated a global epicardial J wave with unipolar recording in both ventricles, suggesting masked early repolarization syndrome type 3.
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