[Brugada syndrome and early repolarization syndrome: similarities and differences. The lesson from case reports]

In subjects with cardiac arrest and aborted sudden death, the presence of an ECG pattern (spontaneous or drug-induced) suggesting a Brugada syndrome (BrS) is generally considered the proof of a BrS. We present three case reports of patients with resuscitated sudden death in whom a BrS was diagnosed, but in whom the real cause was probably an early repolarization syndrome (ERS). This distinction is not only theoretical but has also practical consequences. In fact, the arrhythmic substrate is different in the two conditions: right ventricular outflow tract in BrS, inferior ventricular wall in ERS. As a consequence, catheter ablation of the right ventricular outflow tract may be useful in BrS, whereas it is useless in ERS.