ECG of the Week – 16th June 2021 – Interpretation

You’re reviewing a  44 year old obese patient whose wife has noticed that he is breathing abnormally at night time.

His ECG is as below:


  • Rate: 48
  • Rhythm: sinus
  • Axis: Normal (0-90)
  • Morphology: RSR pattern V1/2, 1mm STD and deep TWI in aVR, 1mm saddleback STE V1 with assoc. +ve-ve TWI, u wave
  • Intervals: PR 140, QRS 100, QTC 376 (Bazetts)
  • Summary: together with a history of possible nocturnal atonal respirations this is suspicious for Brugada Type 3 (but not diagnostic given saddleback change in one lead only)


Specifically in Brugada

  • Syncope
  • Nocturnal agonal respiration
  • Documented VF or polymorphic VT
  • FHx of sudden cardiac death
  • Coved ECG change in family members
  • Unducible VT under programmed electrical stimulation

Further Reading – Textbook:

Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.


Brugada Syndrome