Brugada syndrome diagnostic criteria

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2]

The diagnosis of brugada syndrome is based upon electrocardiographic and clinical criteria. Only the Type I Brugada pattern qualifies as part of the diagnostic criteria for Brugada syndrome. Other rhythm abnormalities and family history are taken into account when making the diagnosis of Brugada syndrome.

• Only the Type I Brugada pattern qualifies as one of the required diagnostic criteria of Brugada syndrome. Type II and Type III EKG patterns do not qualify. Furthermore, the presence of the Type I Brugada pattern is necessary, but is not sufficient to make the diagnosis of Brugada syndrome. Other clinical criteria must be met as well. The diagnosis of Brugada syndrome requires that the criteria below be met:^[1][2][3]
  • The presence of Type 1 ST-segment elevation in more than one right precordial lead (V₁-V₃). Type I Brugada pattern ST elevation must be observed either spontaneously or following the administration of a sodium channel blocking agent.
  • One or more of the following criteria must also be met:
    • Family history of sudden cardiac death (SCD) (<45 years old)
    • Documented ventricular fibrillation (VF)
    • Polymorphic ventricular tachycardia
    • Coved-type ECG changes in family members
    • Inducibility of ventricular tachycardia (VT) with programmed electrical stimulation (PES)
  • The patient is also diagnosed as having Brugada syndrome when a Type 2 (saddleback pattern) or Type 3 ST-segment elevation is observed in more than one right precordial lead under baseline conditions that can be converted to the diagnostic Type 1 Brugada pattern following administration of a sodium channel blocker and the clinical criteria listed above are met as well.

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