Clinical characteristics of Brugada syndrome in a Korean population

The objective of this study was to investigate the clinical features of Korean patients with Brugada syndrome (BS). Between June 1998 and April 2002, 15 consecutive patients with BS (13 men, 2 women; mean age, 44+/-10 years) were identified. Eight patients had experienced at least 1 episode of aborted sudden death, 5 patients had had an episode of syncope or chest pain, and 2 patients were asymptomatic at diagnosis. The electrocardiographics (ECGs) of all patients showed spontaneous ST-segment elevation in leads V(1-3) at baseline and 13 patients (87%) showed transient normalization of the ST-segment elevation during follow-up. Twelve patients received an implantable cardioverter-defibrillator (6 patients with aborted sudden death, 5 patients with syncope or chest pain, 1 asymptomatic patient). During a mean follow-up of 19+/-14 months, arrhythmic events occurred in 5 of the 6 patients with aborted sudden death and in 1 of the 5 patients with syncope or chest pain. None of the asymptomatic patients developed any symptoms suggestive of an arrhythmic event. The clinical and ECG manifestation of BS in Korean patients is diverse, but the dynamic nature of the ST segment provides an important clue to the diagnosis of BS. Recurrence of malignant arrhythmia is extremely high in those patients who initially present with aborted sudden death.