Mechanism and new findings in Brugada syndrome

Brugada syndrome is a clinical entity characterized by coved type ST-segment elevation in the right precordial electrocardiographic leads (V(1-3)) and an episode of ventricular fibrillation in the absence of structural heart disease. Although a number of clinical and experimental reports have elucidated the electrocardiographic, electrophysiologic, cellular, and molecular aspects, several problems remain unsolved. Recently developed high-resolution optical mapping techniques in arterially-perfused wedge preparations enable recording of transmembrane action potentials from 256 sites simultaneously at the epicardial surface, thus providing further advances in the understanding of the cellular mechanism of the specific ST-segment elevation and subsequent ventricular arrhythmias. In this review article, new findings relating to several unresolved problems such as gender difference (male predominance) and ethnic difference (higher incidence in Asian population) are also presented.