Fever-induced Brugada Pattern: How Common Is It and What Does It Mean?

Heart Rhythm. 2013 Sep;10(9):1375-82. doi: 10.1016/j.hrthm.2013.07.030. Epub 2013 Jul 19.

Abstract

Background: Fever is known to unmask the Brugada pattern on the electrocardiogram (ECG) and trigger ventricular arrhythmias in patients with Brugada syndrome. Genetic studies in selected cases with fever-induced Brugada pattern have identified disease-causing mutations. Thus, "fever-induced Brugada" is a recognized clinical entity. However, its prevalence has not been systematically evaluated.

Objective: The purpose of this study was to assess the prevalence of Brugada pattern in consecutive patients with fever.

Methods: ECGs of patients with fever admitted to the emergency department were evaluated for the presence of Brugada pattern and compared with ECGs of consecutive nonfebrile patients.

Results: ECGs of 402 patients with fever and 909 without were evaluated. Type I Brugada pattern was 20 times more common in the febrile group than in the afebrile group (2% vs. 0.1%, respectively, P = .0001). All patients with fever-induced type I Brugada pattern were asymptomatic and remained so during 30 months of follow-up.

Conclusion: Type I Brugada pattern is definitively more common among patients with fever, suggesting that asymptomatic Brugada syndrome is more prevalent than previously estimated.

Keywords: AIDS; Brugada syndrome; ECG; Fever; Ventricular fibrillation; acquired immunodeficiency syndrome; electrocardiogram.

MeSH terms

  • Adult
  • Asymptomatic Diseases
  • Brugada Syndrome / diagnosis
  • Brugada Syndrome / epidemiology*
  • Brugada Syndrome / etiology
  • Comorbidity
  • Exercise Test
  • Female
  • Fever / complications
  • Fever / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies