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Images in Cardiology
9 (
2
); 116-117
doi:
10.25259/IJCDW_38_2023

Exercise-induced Brugada Type I Pattern of ECG in an Asymptomatic Adult

Department of Cardiology, Dr. D. Y. Patil Medical College and Hospital, Pune, Maharashtra, India
Corresponding author: Sridevi Chigullapalli, Department of Cardiology, Dr. D.Y. Patil Medical College and Hospital, Pune, Maharashtra, India. csridevi2007@rediffmail.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Chigullapalli S, Malani SK, Khan A, Wadhokar PS. Exercise-induced Brugada Type I Pattern of ECG in an Asymptomatic Adult. Indian J Cardiovasc Dis Women. 2024;9:116-7. doi: 10.25259/IJCDW_38_2023

Brugada syndrome is a rare hereditary cardiac arrhythmia causing sudden cardiac death in persons with structurally normal hearts. Type 1 Brugada pattern of electrocardiogram (ECG) is seen in patients with Brugada syndrome during rest or seen after provocation with drugs such as ajmaline, procainamide, flecainide, and increased vagal tone or during fever.[1] Adrenergic stimulation with exercise and isoprenaline decreases the elevation of ST segment.[2] Here, we present an ECG image of a patient who developed type I Brugada ECG pattern (right bundle branch block [RBBB], ST elevation with T inversion in V1) during routine stress test which is done for annual health checkup [Figures 1 and 2]. Only few case reports are available which showed exercise-induced type I Brugada pattern.[3] RBBB during exercise can occur rarely as a benign finding in which ST depression is seen V1 and V2 (Lead V1 and Lead V2). RBBB can be rarely due to ischemia during exercise and it is characterized by Q right bundle branch block (RBBB) with ST elevation in V1, V2 and ST depression in V5, V6. In our patient, RBBB with ST elevation in V1 is seen with no ST depression in V5, V6 (Lead V5 and Lead V6).

Figure 1:
Resting ECG showing incomplete RBBB. (ECG: Electrocardiogram, RBBB: Right bundle branch block.)
Figure 2:
ECG during peak exercise showing complete RBBB, ST elevation, and T inversion in V1. (ECG: Electrocardiogram, RBBB: Right bundle branch block, V1: LEAD V1)

Ethical approval

Institutional Review Board approval is not required.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

Dr. C Sridevi is on the editorial board of Journal.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship

Nil.

References

  1. , , , , , , et al. Idiopathic Ventricular Fibrillation Induced with Vagal Activity in Patients without Obvious Heart Disease. Circulation. 1997;95:2275-85.
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  2. , , , , , . Autonomous and Antiarrhythmic Modulation of ST Segment Elevation in Patients with Brugada Syndrome. J Am Coll Cardiol. 1996;27:1061-70.
    [CrossRef] [PubMed] [Google Scholar]
  3. , , , , , , et al. An Unusual Case of Exercise Induced Idiopathic Brugada Electrocardiographic Pattern. Korea Cir J. 2007;37:517-9.
    [CrossRef] [Google Scholar]

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