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(Circulation. 2004;109:1463-1467.)
© 2004 American Heart Association, Inc.

Special Review

Worrisome Thoughts About the Diagnosis and Treatment of Patients With Brugada Waves and the Brugada Syndrome

Joon Ahn, MD; J. Willis Hurst, MD, MACP

From the Emory University School of Medicine, Department of Medicine, Division of Cardiology, Atlanta, Ga.

Correspondence to J. Willis Hurst, MD, MACP, Emory University School of Medicine, Department of Medicine, Division of Cardiology, 1462 Clifton Rd NE, Suite 301, Atlanta, GA 30322. E-mail jhurst{at}emory.edu

The Brugadas have made a significant contribution to medicine. Their discovery of a new clinical syndrome and ECG abnormalities has created a great deal of interest and has opened Pandora’s box. Here, we discuss some worrisome thoughts about the condition. We stress the need for improved diagnostic criteria and treatment because it is not always possible to perform coronary arteriography, electrophysiological studies, right ventricular myocardial biopsy, and MRI in all patients in whom ST-segment abnormalities are seen in the ECG, especially in patients who are asymptomatic. Accordingly, further research is needed to guide the clinician in the diagnostic and therapeutic problems of patients who have unusual ST segments in leads V₁ and V₃. We present a patient who illustrates the problem.

Key Words: Brugada syndrome • diagnosis • electrocardiography • death, sudden • arrhythmia

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