Further Confirmation That a Conduction Disturbance Underlies the Electrocardiographic Pattern of the So-Called Brugada Syndrome

To the Editor:It is a privilege to acknowledge the scientific accuracy of Dr Wilde and coworkers who admitted that some depolarization abnormalities underlie the so-called Brugada syndrome.1 In a previous article, 2 Dr Wilde wrote, "Both theoretical considerations and in vivo experiments support the idea that heterogeneity of repolarization across the wall of the RV outflow tract (RVOT) contribute to the ECG patterns and the genesis of arrhythmias in the Brugada syndrome" (p 669).This recent admission gives further credit to our observation on a patient with the syndrome 20 years ago.3,4 This stillhealthy patient, who can be seen on page 70 of http:// digilander.libero.it/martini_syndrome/,had a documented QRS delay at the right ventricular outflow tract.3 Prolonged PR and HV intervals, left axis deviation, and late potentials both spontaneously and after flecainide were all reported in this syndrome.5 All are consistent with organic disease of the conduction system as documented at necropsy.