Clinical Characteristics of Subjects with the Brugada‐Type Electrocardiogram:

INTRODUCTION: The Brugada-type ECG, a terminal r' wave accompanied by ST segment elevation in the right precordial leads, is not a very rare condition. Most of the cases are men in Japan and elsewhere; however, information about the clinical features of these cases is lacking. The aim of this study was to determine the clinical characteristics of subjects with the Brugada-type ECG, specifically Japanese men. METHODS AND RESULTS: We extracted male Brugada-type ECG cases from 3,374 men followed biennially from 1958 through 2001 in Nagasaki, Japan, and compared the clinical characteristics at diagnosis between these cases and four age-matched male controls for each case. A total of 34 cases with the Brugada-type ECG were observed during follow-up. Body mass index (BMI) at diagnosis was significantly lower in Brugada-type ECG cases than in 136 controls (20.2 +/- 2.1 kg/m(2) vs 21.8 +/- 2.8 kg/m(2), P = 0.003). The BMI trend in cases was always lower than that in controls throughout the 8-year observation period (from 4 years before diagnosis to 4 years after diagnosis). Pulse rate at diagnosis was also somewhat lower in Brugada-type ECG cases than in controls (68.9 +/- 7.7 beats/min vs 72.7 +/- 11.1 beats/min, P = 0.038). The significance disappeared after controlling for BMI (P = 0.131) or body weight (P = 0.153). CONCLUSION: The cases with the Brugada-type ECG had lower BMI than controls, leading to a clue to possible basic mechanisms of the Brugada-type ECG with a focus on this association.