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Challenges in Clinical Electrocardiography |

Life-Threatening ST-Segment Elevation Without Coronary Artery Disease—Discussion

Arch Intern Med. 2011;171(9):801-803. doi:10.1001/archinternmed.2011.185.
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Antzelevitch  CBrugada  PBorggrefe  M  et al.  Brugada syndrome: report of the second consensus conference: endorsed by the Heart Rhythm Society and the European Heart Rhythm Association. Circulation 2005;111 (5) 659- 670
PubMed Link to Article[[XSLOpenURL/10.1161/01.CIR.0000152479.54298.51]]
Alings  MWilde  A “Brugada” syndrome: clinical data and suggested pathophysiological mechanism. Circulation 1999;99 (5) 666- 673
PubMed Link to Article[[XSLOpenURL/10.1161/01.CIR.99.5.666]]
Matsuo  KAkahoshi  MNakashima  ESeto  SYano  K Clinical characteristics of subjects with the Brugada-type electrocardiogram. J Cardiovasc Electrophysiol 2004;15 (6) 653- 657
PubMed Link to Article[[XSLOpenURL/10.1046/j.1540-8167.2004.03544.x]]
Monroe  MHLittmann  L Two-year case collection of the Brugada syndrome electrocardiogram pattern at a large teaching hospital. Clin Cardiol 2000;23 (11) 849- 851
PubMed Link to Article[[XSLOpenURL/10.1002/clc.v23:11]]
Matsuo  KAkahoshi  MNakashima  E  et al.  The prevalence, incidence and prognostic value of the Brugada-type electrocardiogram: a population-based study of four decades. J Am Coll Cardiol 2001;38 (3) 765- 770
PubMed Link to Article[[XSLOpenURL/10.1016/S0735-1097(01)01421-8]]
Brugada  PBrugada  J Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome: a multicenter report. J Am Coll Cardiol 1992;20 (6) 1391- 1396
PubMed Link to Article[[XSLOpenURL/10.1016/0735-1097(92)90253-J]]
Brugada  JBrugada  RAntzelevitch  CTowbin  JNademanee  KBrugada  P Long-term follow-up of individuals with the electrocardiographic pattern of right bundle-branch block and ST-segment elevation in precordial leads V1 to V3. Circulation 2002;105 (1) 73- 78
PubMed Link to Article[[XSLOpenURL/10.1161/hc0102.101354]]
Kamakura  SOhe  TNakazawa  K  et al.  Long-term prognosis of probands with Brugada-pattern ST-elevation in leads V1-V3. Circ Arrhythm Electrophysiol 2009;2 (5) 495- 503
PubMed Link to Article[[XSLOpenURL/10.1161/CIRCEP.108.816892]]
Eckardt  LProbst  VSmits  JP  et al.  Long-term prognosis of individuals with right precordial ST-segment-elevation Brugada syndrome. Circulation 2005;111 (3) 257- 263
PubMed Link to Article[[XSLOpenURL/10.1161/01.CIR.0000153267.21278.8D]]
Epstein  AEDiMarco  JPEllenbogen  KA  et al.  ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation 2008;117 (21) e350- e408
PubMed Link to Article[[XSLOpenURL/10.1161/CIRCUALTIONAHA.108.189742]]
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Figure 2.

Routine electrocardiogram checked 2 days after admission. Type 1 Brugada pattern occurred spontaneously. Note the “sail sign” or “coved type” ST-segment elevation in leads V1and V2(arrows).

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Figure 1.

Electrocardiogram from the patient’s initial presentation in the emergency department.

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