Brugada-type patterns are easily observed in high precordial lead ECGs in collegiate athletes

J Electrocardiol. Jan-Feb 2014;47(1):1-6. doi: 10.1016/j.jelectrocard.2013.08.014. Epub 2013 Oct 2.


Background: Displacement of ECG leads can result in unwarranted findings. We assessed the frequency of Brugada-type patterns in athletes when precordial leads were purposely placed upward.

Methods: Four hundred ninety-one collegiate athletes underwent two ECGs: one with standard leads, one with V1 and V2 along the 2nd intercostal space. A positive Brugada-type pattern was defined as ST elevation in V1 or V2 consistent with a Type 1, 2, or 3 pattern in the high-lead ECG. A control group was comprised of 181 outpatients.

Results: No Type 1 patterns were seen. In 58 athletes (11.8%), a Brugada-type 2 or 3 pattern was observed. Those with Brugada-type 2 or 3 patterns were more likely male, taller, and heavier. In the control group, 18 (9.9%) had Brugada-type 2 or 3 patterns and were more likely male.

Conclusions: Proper lead positioning is essential to avoid unwarranted diagnosis of a Brugada-type ECG, especially in taller, heavier male athletes.

Keywords: Athletes; Brugada-type ECG; ECG; Early repolarization; Electrocardiogram; Electrocardiogram (ECG); HL ECG; High (precordial) lead ECG; SUDS; Screening; UNC; University of North Carolina at Chapel Hill; sudden unexplained death syndrome.

MeSH terms

  • Adult
  • Artifacts
  • Brugada Syndrome / diagnosis*
  • Electrocardiography / instrumentation*
  • Electrocardiography / statistics & numerical data*
  • Electrodes / statistics & numerical data*
  • False Positive Reactions
  • Female
  • Humans
  • Male
  • North Carolina
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Sex Factors
  • Sports / statistics & numerical data*
  • Universities / statistics & numerical data