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Drug-Induced Brugada Type 1 ECG Pattern: Concealed Brugada Syndrome or By-Stander Electrocardiographic Sign?

Pietro Delise

In the clinical setting, drug testing is currently used to unmask a concealed Brugada Syndrome (BrS) both in patients with unexplained syncope and also in asymptomatic subjects with only suspect ECG signs. Recent studies, however, suggest that the induction of a Brugada type 1 ECG (Br type 1 ECG) by drugs may be an aspecific and/or a by-stander ECG sign. This is no idle hypothesis, as in clinical practice drug-induced Br type 1 ECG and BrS are often used as synonyms, feeding worldwide terror of this disease and resulting in an excess of inappropriate aggressive therapies in otherwise healthy subjects.
Condensed abstract: Drug testing is currently used to unmask a concealed Brugada Syndrome in patients with unexplained syncope and also in asymptomatic subjects with suspect ECG signs. Recent studies, however, suggest that the induction of a Brugada type 1 ECG by drugs may be an aspecific and/or a by-stander ECG sign.