Brugada syndrome is a sodium channelopathy with a characteristic ECG pattern (pseudo-right bundle branch block pattern with down sloping ST segment elevation in V1 and/or V2) and an increased risk of sudden cardiac death, in the absence of gross structural heart disease. Type I, or coved-type Brugada pattern, is characterized by ST segment elevation of ≥2 mm with a coved-type morphology in ≥1 right precordial lead. The Brugada type II, or saddle-back pattern, is not diagnostic of Brugada syndrome, and can look similar to an incomplete right bundle branch block with a broad R’ wave. Patients with Brugada syndrome may only manifest typical Brugada morphologies when the channelopathy is unmasked by infections, ischemia, drug use (such as ajmaline, flecainide, or procainamide), or hypokalemia. Patients with Brugada syndrome should be admitted for an automatic implantable internal cardioverter-defibrillator.
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