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! — :) ====================== 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. ================== 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. ------------------------------------ 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!