Prevalence of a Brugada Pattern Electrocardiogram in an Urban Population in the United States

OBJECTIVE: To determine the prevalence of a Brugada-type pattern on routine electrocardiogram (ECG) in an urban population served by a tertiary medical center in the United States. METHODS: The investigators reviewed the ECG database at the Montefiore Medical Center, a tertiary teaching center in the Bronx, New York, over a 10-year period. During this time, 653,006 ECG records in 162,590 patients were identified. The database was queried by applying standard diagnostic criteria in an attempt to identify records with apparent conduction delay and ST abnormality in leads V1-V3. Additional diagnostic criteria were then applied to identify records in an attempt to mimic Brugada-like changes. A cardiac electrophysiologist reviewed records meeting these criteria to confirm the presence of a Brugada-type pattern. RESULTS: In total, 16,067 patients (9.8%) were identified as having ECGs with right bundle branch block, incomplete right bundle branch block, or RSR' in leads V1 and V2. After applying additional diagnostic criteria evaluating ST segment shift, 456 patients were identified as having a pattern potentially consistent with a Brugada-type ECG. The presence of a Brugada-type pattern was confirmed by physician overread in 20 patients (0.012%). CONCLUSION: The Brugada-type ECG pattern is infrequently seen in a large ethnically diverse urban US population. Further evaluation should be considered when this pattern is seen on routine ECG.