Fever-induced Brugada pattern: how common is it and what does it mean?

Area of Science:

• Cardiology
• Clinical Electrophysiology
• Genetics

Background:

• Fever can unmask Brugada pattern on ECG and trigger arrhythmias in Brugada syndrome patients.
• Disease-causing mutations have been identified in some fever-induced Brugada cases.
• Fever-induced Brugada is recognized, but its prevalence is unknown.

Purpose of the Study:

• To determine the prevalence of Brugada pattern in patients presenting with fever.

Main Methods:

• ECGs of 402 febrile patients were analyzed for Brugada pattern.
• ECGs were compared to those of 909 consecutive afebrile patients.

Main Results:

• Type I Brugada pattern was 20 times more frequent in febrile patients (2%) than afebrile (0.1%).
• All patients with fever-induced Type I Brugada pattern were asymptomatic.
• Asymptomatic status was maintained during a 30-month follow-up period.

Conclusions:

• Type I Brugada pattern is significantly more common in patients with fever.
• This suggests a higher prevalence of asymptomatic Brugada syndrome than previously estimated.