Prevalence and significance of the early repolarization pattern in inferolateral leads in patients with Brugada syndrome: A single-center study

In this study, the prevalence and prognostic significance of the early repolarization (ER) pattern in the inferolateral leads in patients with Brugada syndrome were investigated. Clinical, genetic, and electrophysiological data were collected and analyzed from 69 individuals with either a spontaneous or drug-induced Brugada type 1 electrocardiogram (ECG) pattern. An ER pattern was defined as J-point elevation at least 0.1 mV from the baseline in at least 2 inferior or lateral leads. The presence of late potentials and inducibility of ventricular fibrillation (VF) by programmed stimulation were compared between patients with and without a J wave. Follow-up data, including outcome events, were obtained for all patients. An ER pattern was observed in the inferolateral leads in 6 patients with a spontaneous Brugada type 1 ECG pattern and in 1 patient with a drug-induced Brugada type 1 ECG pattern. There was no significant intergroup difference in symptoms, family history of sudden cardiac death, prevalence of late potentials, or inducibility of VF. No patient with the ER pattern developed a cardiac event during the mean follow-up period of 73.6±38.1 months. The ER pattern in the inferolateral leads is not uncommon in Brugada syndrome; however, the presence of a J wave does not appear to be associated with subsequent arrhythmic events in patients with Brugada syndrome.