Transient Brugada-type electrocardiographic abnormalities in renal failure reversed by dialysis

Brugada Syndrome: Report of the Second Consensus Conference

“…Importantly, confounding factor or factors that could account for the ECG abnormality or syncope should be carefully excluded, including atypical right bundle-branch block, left ventricular hypertrophy, early repolarization, acute pericarditis, acute myocardial ischemia or infarction, pulmonary embolism, Prinzmetal angina, 21 dissecting aortic aneurysm, 22 various central and autonomic nervous system abnormalities, 23,24 Duchenne muscular dystrophy, 25 thiamin deficiency, 26 hyperkalemia, 22,27,28 hypercalcemia, 29,30 arrhythmogenic right ventricular dysplasia/cardiomyopathy, 31,32 pectus excavatum, 33 hypothermia, 34,35 and mechanical compression of the right ventricular outflow tract (RVOT) as occurs in mediastinal tumor 36 or hemopericardium. 37 Of note, a Brugada-like ECG can occasionally appear for a brief period or for a period of several hours after directcurrent cardioversion; it is not known whether these patients are gene carriers for Brugada syndrome.…”

Hyperkalemia‐Induced Brugada Pattern with Electrical Alternans

“…Prompt recognition of this electrocardiographic entity may expedite the initiation of appropriate diagnosis and treatment. Reviewing literatures in recent 10 years, we can conclude that the hyperkalemia Brugada sign usually developed as follows: (1) Serum potassium levels were usually 5.8–9.4 mmol/l; (2) Patients were always in critically ill or administrated medicine that could block sodium channel and prolong QT‐interval, or committed cocaine challenge, alcohol intoxication, hyperglycemia, hyponatremia, thiamine deficiency, fever, and so on; (3) ECG characteristics of patients who exhibited the hyperkalemic Brugada sign manifest widened QRS complex, axis shifts, and especially loss of P waves. These clinical and electrocardiographic characteristics not only differentiate it from the genetic‐type Brugada but also may be an indication of severe and possibly life‐threatening hyperkalemia.…”

Brugada Syndrome: Overview

“…Myocarditis 47 Atypical right bundle branch block Left ventricular hypertrophy Early repolarization Acute pericarditis Acute myocardial ischemia or infarction Pulmonary embolism Prinzmetal's angina 191 Dissecting aortic aneurysm 192 Various central and autonomic nervous system abnormalities 193,194 Duchenne muscular dystrophy 195 Thiamine deficiency 196 Hypokalemia 155,197 Hyperkalemia 192,198,199 Hypercalcemia 200,201 Arrhythmogenic right ventricular dysplasia/cardiomyopathy 45,46 Hypothermia 202,203 Mechanical compression of right ventricular outflow tract as with mediastinal tumor 204 Hemopericardium 205 Fatty acid oxidation disorder (medium chain Acyl-CoA dehydrogenase deficiency) 206 Type 2 increases by ≥2 mm; (3) premature ventricular beats or other arrhythmias develop; or (4) QRS widens to ≥130% of baseline. Sodium channel blockers should be used with particular caution in the presence of atrial and/or ventricular conduction disease (presence of wide QRS, wide P waves, or prolonged PR intervals).…”