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Module title = Tutorial: Bundle Branch Blocks
Lesson title = Advanced details
This is lesson 8 of 8 in this module
Brugada syndrome:
is listed here because it can mimic or be associated with RBBB
Brugada syndrome is caused by a
sodium or calcium channel mutation
and is a cause of sudden onset ventricular tachycardia or ventricular fibrillation in children and adults
the
diagnostic criteria
for Brugada syndrome is
J point elevation with ST elevation in V
1
-V
3
the ST is described as coved or saddlebacked:
coved
= downsloping and convex upward
saddlebacked
= flat ST elevation with initial and final parts of ST segment slightly higher
the ST is abnormal because the abnormal ion channels result in electrical currents during the ST segment (during which in a normal heart, there is typically little to no current movement)
There are 3 types of Brugada syndrome. Type 1 has the "coved" ST and types 2 and 3 have the saddleback morphology:
Coved ST Saddleback ST
Brugada syndrome does not cause a wide QRS nor an R' wave. However, the
ST elevation can be misinterpretted as an R' wave
. When this happens, the QRS would erroneously be seen as wide.
remember that the ST segment in RBBB should be isoelectric and flat (blue circle). In these 2 examples, it is actually slightly depressed in fact:
Lesson 8 of 8
That was the last lesson!
