gms | German Medical Science

33. Internationale Konferenz für Elektrokardiographie

Internationale Konferenz für Elektrokardiographie

Brugada Syndrome and Short QT Interval: A new diagnosis?

Meeting Abstract

  • corresponding author presenting/speaker R. Schimpf - Department of Cardiology, Mannheim, Germany
  • L.F. Hsu - Hopital Cardiologique du Haut-Leveque, Bordeaux, France
  • C. Veltmann - Department of Cardiology, Mannheim, Germany
  • M. Haissaguerre - Hopital Cardiologique du Haut-Leveque, Bordeaux, France
  • S. Schickel - Protestant Hospital, Oberhausen, Germany
  • R. Oberheiden - Protestant Hospital, Mannheim, Germany
  • M. Borggrefe - Department of Cardiology, Mannheim, Germany
  • C. Wolpert - Department of Cardiology, Mannheim, Germany

33rd International Congress on Electrocardiology. Cologne, 28.06.-01.07.2006. Düsseldorf, Köln: German Medical Science; 2007. Doc06ice097

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Veröffentlicht: 8. Februar 2007

© 2007 Schimpf et al.
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Critical for the diagnosis of primary electrical diseases such as the long QT-syndrome, the Brugada syndrome and the short QT syndrome is the ECG. However, fluctuations of the depolarization and repolarization with a change from a clear pathological to an only suspicious or even normal pattern may complicate diagnosis. Phenotypic overlap findings are known with e.g. precordial QT polongation in patients with a Brugada syndrome. Aim of the actual study was to screen for a shortening of the QT time in a collective of patients with a Brugada syndrome for potential overlap syndromes.

Patient and methods: 44 consecutive patients with a Brugada syndrome (mean age 44 ± 12 years, 28 men, 16 women) were enclosed in the study. Apart from the index ECG consecutive follow-up ECGs were analyzed with respect to morphological changes of the cardiac repolarization (type I-, II-, III-ECG or normal finding). Furthermore, the QT interval was determined.

Results: The mean QT interval of all patients and ECGs was 411 ± 33 msec. 40% of ECGs presented with a normal finding. In contrast three patients, which were symptomatic with syncopes and aborted sudden cardiac death presented with a shortened QT-interval of 327±10ms (relative QT Interval 85.7%±0.6) in all and not only in the precordial leads. One patient showed during follow-up a type-I ECG, the other patients presented apart form the QT shortening a type-I pattern during intravenous drug challenge (ajmaline). Mean ventricular refractory periods were shortened (170±8ms) in this group and in one patient ventricular fibrillation could be induced during programmed ventricular stimulation. Clinical implications: 1) 7% of the patients with a Brugada syndrome presented with a shortened QT interval. 2) At present it is unclear whether we deal with a short QT syndrome or a Brugada syndrome. 3) It has to be examined, whether gain-of-function mutations with a shortened cardiac repolarization period may induce a type I ECG.