ECG Video-14 (Blog 117) - Brugada Syndrome (9-7.1-2015)

Please NOTE (10/21/2021): I have updated my content and ECG Videos on Brugada Phenocopy & Brugada Syndrome — in my ECG Blog #238 — https://ecg-interpretation.blogspot.c... — Please CHECK THIS OUT — and feel free to correspond with me via my ECG Blog website (at that link). THANK YOU! — :)

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This 29-minute video reviews ECG recognition of Brugada patterns and the essentials of management for the non-cardiologist. There is focus on distinction from right bundle branch block and normal variant patterns, with suggestions on when to refer.

NOTE-1: Links to my ECG Videos (including a folder with Power Point Shows of these videos) — as well as info on my other ECG Resources can be found at — http://www.videoecg.com — Your Questions and Feedback are welcome!

NOTE-2: To facilitate viewing, with rapid access to specific topics of interest — I have developed a Timed CONTENTS with LINKS (http://ecg-interpretation.blogspot.co... ) — This allows instant Fast Forward on YouTube to the content you are searching for.
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ADDENDUM (10/24/2020): In the past, the diagnosis of Brugada Syndrome required not only the presence of a Brugada-1 ECG pattern — but also a history of sudden death, sustained VT, non-vasovagal syncope or a positive family history of sudden death at an early age. This definition was changed following an expert consensus panel in 2013 — so that at the present time, all that is needed to diagnose Brugada Syndrome is a spontaneous or induced Brugada-1 ECG pattern, without need for additional criteria.
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TIMED CONTENTS (Click on Links to Fast Forward! ):
0:00 – Introduction (How to contact me).
1:04 – Let’s Begin with a Case: What is Missing?
1:50 – A Closer Look at Leads V1, V2, V3 (Type-1/Ski-Slope).
2:10 – Brugada Pattern vs Syndrome.
3:00 – vs Brugada Type-2 Pattern (Saddleback).
4:20 – WHAT is Brugada Syndrome? (Channelopathy)
5:24 – Brugada Patterns may be Intermittent …
6:20 – On ECG: Why are changes seen in V1,2,3?
7:13 – Male Predominance (Genetics are complicated).
8:12 – Precipitating Factors (Drugs/Other Conditions … ).
9:17 – Brugada Phenocopy (ECG changes transient … ).
10:01 – Repositioning Electrodes (to the 2nd, 3rd IS).
11:13 – What to Do Clinically? (Refer? / Need for ICD? ).
11:59 – Scenario #1: Young healthy patient/Saddleback …
12:42 – Scenario #2: Older patient/Type-1 changes …
13:30 – What Brugada Syndrome is Not (Lead placement … ).
14:51 – On ECG: Recognizing if V1, V2 leads are placed too high.
15:20 – Saddleback vs IRBBB (or rsr’ ) vs Normal Variant
15:58 – What about Athletes? – Special ECG considerations …
16:40 – PRACTICE Tracing: Saddleback on Pre-Participation ECG.
19:15 – KEYPOINTS: Criteria for Brugada ECG Patterns.
20:18 – Brugada Type-1 Pattern (ST elevated at 80 msec).
21:17 – vs BrugadaType-2 (β-Angle: 5mm down; ≥4mm wide).
24:05 – Back to the Case: Applying Brugada pattern criteria …
26:32 – Final CASE: Acute Inferior STEMI with Brugada pattern?
28:56 – That’s it for today!