Abstract P132: Blazing Saddles: The Brugada-pattern Electrocardiographic Characteristics in a Large Southwestern Teaching Hospital
Purpose: The Brugada syndrome has important clinical implications. As there is an increasing awareness of this disease state, the Brugada-pattern has been identified in many patients, often associated with other illnesses, in the absence of the syndrome. The characteristics of these patients in a large teaching hospital in the United States have yet to be elucidated.
Methods: In a seven month period between July, 2007, and July, 2008, 26,142 electrocardiograms (ECGs) were reviewed in a large southwestern teaching hospital and referral center. A total of 363 ECGs in 301 patients were identified with one or more of the Brugada patterns (1, 2, or 3). A retrospective chart review was then performed.
Results: The Brugada pattern ECG was present in 2% of our population. Ages ranged from 17–102. Median age was 58 years, mean age was 58.4 years. The majority, 47%, manifested the Type 2 (“elevated saddleback”) Brugada pattern, whereas 38% displayed the Type 3 Brugada pattern. A minority of the patients, 14%, had the Type 1 Brugada pattern. Fifty-five percent were male, and 58% were Caucasian. Only one male patient with the Type 1 Brugada pattern was diagnosed with the Brugada syndrome. Males were more likely to display a Brugada-pattern ECG compared to females (p=0.0035), primarily the Type 2 Brugada pattern. Female patients were more likely to display a Type 1 or Type 3 pattern. Additionally, race influenced the type of Brugada pattern (p=0.04). Caucasians, African Americans, and Asians were more likely to have a Type 3 pattern and Hispanics a Type 2 pattern. Fifty percent presented with a chief complaint of chest pain. Fifty-one percent were troponin positive. Patients admitted with chest pain were more likely to exhibit a Brugada pattern ECG than their counterparts having ECGs for other diagnoses, OR 11 (p<0.001).
Conclusion: The Brugada-pattern ECG is more common than previously encountered. In our study, the primary etiology was acute coronary syndrome. To our knowledge, this is the largest single center study in the United States to date to elucidate the associated patient characteristics of this important ECG finding. Further studies will need to be performed to determine the prognostic significance of the Brugada-pattern ECG in the absence of apparent Brugada syndrome.