Computer simulation of atypical Brugada syndrome

Recently, the so-called atypical Brugada syndrome (BS) has been reported in few cases in literature. The typical BS is characterized by ST-segment elevation in the right precordial leads, whereas atypical forms of the disease are distinguished by electrocardiogram abnormalities of the J wave, and ST-segment elevation appeared in the inferior and lateral leads. In this work, we report a simulation of atypical BS based on a 3-dimensional whole-heart model. By setting the action potentials of Brugada model cells in different epicardial regions, we calculated 12-lead electrocardiogram and body surface potentials that are in good agreement with clinical data. Applying additional electrical stimuli, we obtained the induction of ventricular fibrillation in both typical and atypical BS forms. The calculated results confirm possibility of similar electrophysiological basis in both cases and suggest that BS can also be observed in inferior and lateral precordial leads.