Prevalence and characteristics of the Brugada electrocardiogram pattern in patients with arrhythmogenic right ventricular cardiomyopathy

Nobuhiko Ueda, Satoshi Nagase, Naoya Kataoka, Kenzaburo Nakajima, Tsukasa Kamakura, Mitsuru Wada, Kenichiro Yamagata, Kohei Ishibashi, Yuko Inoue, Koji Miyamoto, Takashi Noda, Takeshi Aiba, Chisato Izumi, Teruo Noguchi, Seiko Ohno, Kengo Kusano

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background: Despite distinct pathophysiology, arrhythmogenic right ventricular cardiomyopathy (ARVC) and Brugada syndrome (BrS) exhibit overlapping phenotypes. We investigated the prevalence and characteristics of the Brugada electrocardiogram (ECG) pattern in ARVC patients. Methods: A total of 114 ARVC patients fulfilling the revised Task Force Criteria were enrolled. The Brugada ECG pattern was evaluated according to the consensus report on right precordial leads, and 1141 ECGs (median, 1; interquartile range, 1-16 ECGs/patient) were analyzed. Results: Five patients (4%) showed a Brugada ECG pattern, which disappeared in four patients with ECGs recorded more than 2 years afterward. ARVC patients with the Brugada ECG pattern had a longer PQ interval (220 ± 62 ms vs 180 ± 35 ms, P =.02) and longer QRS duration (138 ± 25 ms vs 102 ± 23 ms, P <.001) than patients without the pattern. During follow-up (median, 11.4; interquartile range, 5.5-17.1 years), 19 ARVC patients experienced cardiac death and 29 experienced heart failure (HF) hospitalization. Kaplan-Meier analysis determined that the Brugada ECG pattern increased the risk of cardiac death and HF hospitalization (log-rank; P <.001, P <.001 respectively). The mean J-point and S-wave amplitudes of the Brugada ECG pattern were 0.29 ± 0.05 mV and 0.34 ± 0.21 mV, respectively, which were significantly lower than those of 26 age-matched BrS patients with a previous ventricular fibrillation episode (0.66 ± 0.33 mV, P <.001 and 0.67 ± 0.39 mV, P =.02 respectively). Conclusion: The Brugada ECG pattern was infrequently encountered, was transient in ARVC patients, and was associated with a longer PQ interval, longer QRS duration, and cardiac events.

Original languageEnglish
Pages (from-to)1173-1183
Number of pages11
Journaljournal of arrhythmia
Issue number5
Publication statusPublished - 2021 Oct
Externally publishedYes


  • Brugada syndrome
  • arrhythmogenic right ventricular cardiomyopathy
  • cardiac death
  • depolarization abnormality
  • heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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