Spontaneous Brugada electrocardiogram patterns are rare in the German general population: results from the KORA study.

Aims: The Brugada syndrome is a rare, potentially fatal primary cardiomyopathy. Patients are identified by symptoms and typical electrocardiogram (ECG) patterns. Prevalence of spontaneous Brugada ECG patterns in the general population is unknown.
Methods and Results: We analysed 12-lead resting ECGs of 4149 men and women aged 25-74 years from the population-based KORA Study. Computer-assisted analysis identified ECGs with J-point elevation in leads V1-V3 and QRS duration <or=150 ms. Positive ECGs were re-evaluated independently by expert cardiologists. Computer-assisted analysis identified 250/4149 ECGs, predominantly from male probands (206/250) who were younger (41.0 +/- 11.9 vs. 52.1 +/- 13.8 years, P < 0.0001) than males without the ECG sign. After expert review, not a single ECG showed a Brugada ECG pattern. A high percentage of ECGs were considered abnormal, the majority (73) showing left-ventricular hypertrophy. Manual analysis of a representative, randomly selected sample of 351 ECGs without computer-assisted pre-analysis revealed not a single Brugada ECG pattern. True Brugada patterns were reliably identified by screening of a control subset of patients.
Conclusion: Spontaneous Brugada ECG patterns are rare in the general population and may hence constitute a relevant biological signal. Computer-aided analysis can help to identify abnormal ECGs.