Discrimination of Brugada syndrome patients from individuals with the saddle-back type ST-segment elevation using a marker of the standard 12-lead electrocardiography

Background In the clinical situation, the saddle-back (S-B) type is more frequently detected than the coved type. In the present study, the discrimination of Brugada syndrome from the S-B type individuals using a marker of the standard 12-lead electrocardiography (ECG) was attempted. Methods and Results The study group consisted of 55 individuals with the S-B type in whom pilsicainide provocation test (PLC test) was carried out. The time from the onset of the QRS wave in lead V-2 (IV2) to the peak of the late R-like wave in the QRS wave (PV2), and the time from IV2 to the offset of the QRS wave in lead V-5 (EV5) were measured. The coved type was induced by the PLC test in 29 cases (N-C group), but not in the remaining 26 cases (N-N group). The (IV2 - PV2) - (IV2 - EV5) value before the PLS test was greater in the N-C group than in the N-N group. The negative predictive value of '(IV2-PV2)-(IV2-EV5) >= 0' was 76.4% for the prediction of a positive PLC test. Conclusions A '(IV2-PV2)-(IV2-EV5) >= 0' is a useful ECG marker for the discrimination of Brugada syndrome in the S-B type individuals.