• Marine Arnaud, Pauline Berthome, Romain Tixier, Jean Briand, Olivier Geoffroy, Xavier Le Guillou, Dominique Babuty, Jacques Mansourati, Laurence Jesel, Jean-Marc Dupuis, Paul Bru, Florence Kyndt, Béatrice Guyomarch, Aurélie Thollet, Nathalie Behar, Philippe Mabo, Frédéric Sacher, Vincent Probst, and Jean-Baptiste Gourraud.
• L'Institut du thorax, Inserm, CNRS, université de Nantes, CHU de Nantes, 44093 Nantes, France.
• Arch Cardiovasc Dis. 2020 Mar 1; 113 (3): 152-158.

BackgroundThe recently recommended single lead-based criterion for the diagnosis of Brugada syndrome may lead to overdiagnosis of this disorder and overestimation of the risk of sudden cardiac death.AimTo investigate the value of a single-lead diagnosis in patients with Brugada syndrome and a spontaneous type 1 electrocardiogram.MethodsConsecutive patients with Brugada syndrome were included in a multicentre prospective registry; only those with a spontaneous type 1 electrocardiogram were enrolled. Clinical and electrocardiogram data were reviewed by two physicians blinded to the patients' clinical and genetic status.ResultsAmong 1613 patients, 505 (31%) were enrolled (79% male; mean age 46±15 years). A spontaneous type 1 electrocardiogram pattern was found in one lead in 250 patients (group 1), in two leads in 227 patients (group 2) and in three leads in 27 patients (group 3). Groups were similar except for individuals in group 3, who presented more frequently a fragmented QRS complex, an early repolarization pattern and a prolonged Tpeak-Tend interval. After a mean follow-up of 6.4±4.7 years, ventricular arrhythmia, sudden cardiac death or implantable cardiac defibrillator shock occurred in 46 (9%) patients, without differences between groups.ConclusionThe prognosis of Brugada syndrome with a spontaneous type 1 electrocardiogram pattern does not appear to be affected by the number of leads required for the diagnosis.Copyright © 2019 Elsevier Masson SAS. All rights reserved.

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