Abstract 2253: The association of Brugada pattern type 1 and fever: a retrospective analysis
INTRODUCTION: Many precipitants of the Brugada pattern ECG have been identified, including fever. However, the association of fever with Brugada pattern type is unknown. We assessed the hypothesis that the Brugada pattern ECGs that occur in the setting of a febrile episode are related to the Brugada pattern type.
METHODS: This retrospective study examined all ECGs performed at Columbia University Medical Center from October 2004 to March 2007. The ECGs identified as showing possible Brugada pattern were reviewed and classified according to the ECG criteria endorsed by the Heart Rhythm Society and European Heart Rhythm Association. The medical record was then investigated for documentation of fever, defined as a temperature greater than or equal to 38.0 degrees Celsius. The primary outcome was the presence of fever within 48 hours of the Brugada pattern ECG.
RESULTS: Forty Brugada pattern ECGs were identified (21 type 1 and 19 type 2). Background characteristics of the patients according to Brugada pattern type are shown in the Table⇓. Eleven patients (27.5%) had fever (median temperature 38.4; temperature range 38.0 – 40.1) and Brugada pattern ECGs. There was a statistically significant association of Brugada pattern type 1 (nine patients) and fever compared to Brugada pattern type 2 (two patients) and fever (p=0.031; OR 6.96, 95% CI 1.26 – 38.44). Seven of nine patients (77.7%) with fever and Brugada pattern type 1 had a normal ECG when afebrile and one of two patients (50.0%) with fever and Brugada pattern type 2 had a normal ECG when afebrile.
CONCLUSIONS: A significant number of patients with Brugada pattern type 1 had this ECG finding in the context of fever. The majority of these patients had a normal ECG when afebrile. Further investigation is needed to assess the biologic plausibility of this finding as well as the relationship of Brugada pattern type 1 unmasked by fever in asymptomatic patients to the clinical features of Brugada syndrome.