The Brugada ECG and Schizophrenia
The type 1 coved ST-segment Brugada ECG pattern is said to be unusual in a general population, perhaps occurring in 0.1% of European descent populations,1 and possibly more often, ≤0.2%, in East Asians.2,3 Therefore, it is surprising that in this issue of Circulation: Arrhythmia and Electrophysiology, Blom et al4 report identifying a Brugada ECG pattern in 11.6% (32/275) of patients with schizophrenia. The finding is unexpected and may carry interesting implications both for mechanisms and for patient care.
Article see p 384
Could This Be a False-Positive Result?
Only 1 subject had the definitive type 1 ECG pattern, and the other 31 had the less specific type 2 to 3 pattern, whose frequency in the general population has not been well established. The authors did examine the prevalence of the Brugada ECG pattern in 2 control groups. In a small group of young healthy population controls, the type 2 to 3 pattern was seen in 2/179 (1.1%) subjects, whereas in a group of older population controls, the prevalence was 28/1168 (2.4%). In the present study, 23 of the 31 patients with the type 2 to 3 pattern consented to provocative testing with ajmaline and 10/23 then displayed the type 1 pattern. Although there was no family or personal history of syncope of cardiac arrest, this finding adds weight to the conclusion that the high prevalence of the pattern seems to be a real finding. There was no type 1 ECG in either control group, and for study design reasons the controls were not accessible for …