A comprehensive electrocardiographic, molecular, and echocardiographic study of Brugada syndrome: Validation of the 2013 diagnostic criteria

Simone Savastano, Roberto Rordorf, Alessandro Vicentini, Barbara Petracci, Erika Taravelli, Silvia Castelletti, Alessandra D'Errico, Margherita Torchio, Cinzia Dossena, Paola Novara, Federica Dagradi, Maurizio Landolina, Carla Spazzolini, Lia Crotti, Peter J. Schwartz

Research output: Contribution to journalArticle


Background The debate on the diagnostic value of high intercostal spaces (ICSs) and of the number of diagnostic leads in Brugada syndrome (BrS) has been settled by a recent expert consensus statement. Objective To test the validity, and the underlying anatomy, of the new electrocardiographic (ECG) diagnostic criteria using echocardiographic, molecular, and clinical evidence in 1 clinical study population with BrS. Methods We analyzed 114 patients with BrS and with a spontaneous or drug-induced type 1 ECG pattern recorded in 1 or more right precordial leads in fourth, third, and second ICSs. The right ventricular outflow tract (RVOT) was localized by using echocardiography. All probands were screened on the SCN5A gene. Results The percentage of mutation carriers (MCs) and the event rate were similar regardless of the diagnostic ICS (fourth vs high ICSs: MCs 23% vs 19%; event rate 22% vs 28%) and the number of diagnostic leads (1 vs 2: MCs 20% vs 22%; event rate 22% vs 27%). The concordance between RVOT anatomical location and the diagnostic ICSs was 86%. The percentage of the diagnostic ECG pattern recorded was significantly increased by the exploration of the ICSs showing RVOT by echocardiography (echocardiography-guided approach vs conventional approach 100% vs 43%; P

Original languageEnglish
Pages (from-to)1176-1183
Number of pages8
JournalHeart Rhythm
Issue number7
Publication statusPublished - 2014



  • Brugada syndrome
  • Diagnostic criteria
  • Echocardiography
  • Electrocardiography
  • SCN5A

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

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