ECG Video-14 (Blog 117) - Brugada Syndrome (9-7.1-2015)

Please NOTE (10/21/2021): I have updated my content and ECG Videos on Brugada Phenocopy & Brugada Syndrome - in my ECG Blog #238 - ecg-interpretation.blogspot.c... - Please CHECK THIS OUT - and feel free to correspond with me via my ECG Blog website (at that link). THANK YOU! - :)
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This 29-minute video reviews ECG recognition of Brugada patterns and the essentials of management for the non-cardiologist. There is focus on distinction from right bundle branch block and normal variant patterns, with suggestions on when to refer.
NOTE-1: Links to my ECG Videos (including a folder with Power Point Shows of these videos) - as well as info on my other ECG Resources can be found at - www.videoecg.com - Your Questions and Feedback are welcome!
NOTE-2: To facilitate viewing, with rapid access to specific topics of interest - I have developed a Timed CONTENTS with LINKS (ecg-interpretation.blogspot.co... ) - This allows instant Fast Forward on KZread to the content you are searching for.
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ADDENDUM (10/24/2020): In the past, the diagnosis of Brugada Syndrome required not only the presence of a Brugada-1 ECG pattern - but also a history of sudden death, sustained VT, non-vasovagal syncope or a positive family history of sudden death at an early age. This definition was changed following an expert consensus panel in 2013 - so that at the present time, all that is needed to diagnose Brugada Syndrome is a spontaneous or induced Brugada-1 ECG pattern, without need for additional criteria.
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TIMED CONTENTS (Click on Links to Fast Forward! ):
0:00 - Introduction (How to contact me).
1:04 - Let’s Begin with a Case: What is Missing?
1:50 - A Closer Look at Leads V1, V2, V3 (Type-1/Ski-Slope).
2:10 - Brugada Pattern vs Syndrome.
3:00 - vs Brugada Type-2 Pattern (Saddleback).
4:20 - WHAT is Brugada Syndrome? (Channelopathy)
5:24 - Brugada Patterns may be Intermittent …
6:20 - On ECG: Why are changes seen in V1,2,3?
7:13 - Male Predominance (Genetics are complicated).
8:12 - Precipitating Factors (Drugs/Other Conditions … ).
9:17 - Brugada Phenocopy (ECG changes transient … ).
10:01 - Repositioning Electrodes (to the 2nd, 3rd IS).
11:13 - What to Do Clinically? (Refer? / Need for ICD? ).
11:59 - Scenario #1: Young healthy patient/Saddleback …
12:42 - Scenario #2: Older patient/Type-1 changes …
13:30 - What Brugada Syndrome is Not (Lead placement … ).
14:51 - On ECG: Recognizing if V1, V2 leads are placed too high.
15:20 - Saddleback vs IRBBB (or rsr’ ) vs Normal Variant
15:58 - What about Athletes? - Special ECG considerations …
16:40 - PRACTICE Tracing: Saddleback on Pre-Participation ECG.
19:15 - KEYPOINTS: Criteria for Brugada ECG Patterns.
20:18 - Brugada Type-1 Pattern (ST elevated at 80 msec).
21:17 - vs BrugadaType-2 (β-Angle: 5mm down; ≥4mm wide).
24:05 - Back to the Case: Applying Brugada pattern criteria …
26:32 - Final CASE: Acute Inferior STEMI with Brugada pattern?
28:56 - That’s it for today!

Пікірлер: 26

  • @collinlo5525
    @collinlo55257 жыл бұрын

    Thank you so much for your video, sir!

  • @FrankenDoctor
    @FrankenDoctor8 жыл бұрын

    Thank you for another informative presentation.

  • @isharakumarasinghe6429
    @isharakumarasinghe64296 жыл бұрын

    that was an awesome explanation. thank u so much sir!

  • @mamunshikder8542
    @mamunshikder85424 жыл бұрын

    Presentation is very much impressive & helpful to me.Thanks a lot sir..🙂

  • @alibewilder6034
    @alibewilder60348 жыл бұрын

    thanks a lot professor

  • @mdsomanmiah7537
    @mdsomanmiah75373 жыл бұрын

    Very simplified.thanks a lot sir

  • @-ecgvideoblog-kengrauermd1821

    @-ecgvideoblog-kengrauermd1821

    3 жыл бұрын

    THANK YOU for the kind words - :)

  • @patriciamina2845
    @patriciamina28458 жыл бұрын

    i find this material very helpfull the content is very extense and the way that you describe things is very educational . thanks

  • @kg-photos4292

    @kg-photos4292

    8 жыл бұрын

    Thank you Patricia! - :)

  • @mostafaalwan2999
    @mostafaalwan29998 жыл бұрын

    Thank you very much sir for excellent and unique lecture , we appreciate your efforts for simplifying Brugada Syndrome :)

  • @-ecgvideoblog-kengrauermd1821

    @-ecgvideoblog-kengrauermd1821

    8 жыл бұрын

    +mostafa alalwan - THANKS for the positive feedback. Note that I will very shortly complete a LINKED CONTENTS to this Video, that should facilitate rapid access to specific parts of the presentation (GO TO - ecg-interpretation.blogspot.com/p/c-lick-h-ere-to-get-back-to-my-ecg-blog_16.html ).

  • @dannytetreault
    @dannytetreault6 жыл бұрын

    I am a cardio tech at a local hospital here in Nanaimo, BC. I am quickly becoming a fan of your channel and content. You are an excellent teacher.

  • @kg-photos4292

    @kg-photos4292

    6 жыл бұрын

    Thank you so much for the kind words! - :)

  • @hecmunozob
    @hecmunozob5 жыл бұрын

    Thanks professor Grauer. Invaluable teaching points we should remember. chapau. H Munoz, MD Caracas, Venezuela.

  • @kg-photos4292

    @kg-photos4292

    5 жыл бұрын

    Glad my video was helpful! - :)

  • @TvAanimalia
    @TvAanimalia2 жыл бұрын

    thank You very much sir

  • @kg-photos4292

    @kg-photos4292

    2 жыл бұрын

    Thanks for your interest. I updated this video here - Blog #238 - tinyurl.com/KG-Blog-238 - :)

  • @912352787
    @9123527877 жыл бұрын

    Fantaaaastic

  • @kg-photos4292

    @kg-photos4292

    7 жыл бұрын

    Thank you - :)

  • @davidlu9926
    @davidlu99263 жыл бұрын

    This is an amazing and excellent explanation of brugada! It’s the most detailed explanation video on the internet for sure. This will help in many clinical settings and students like myself a lot. Just one question: does confirmatory type 2 brugada criteria involve more than one leads (V1-V3)? If saddleback morphology is only found in one single lead, say V1, but not V2 or V3, does that fit the criterion for type 2?

  • @KenGrauer

    @KenGrauer

    3 жыл бұрын

    @ GZ - Thanks so much for the positive feedback! Please be SURE that you have looked at my notes for this video (Click on SHOW MORE under the Video) - especially the Addendum I added on 10/24/2020, as the way Brugada-1 is defined has changed since I made this video. Other than that - the video remains current. As to your question - yes, you can diagnose a Brugada-2 (Saddleback) morphology from a single lead - but remember that a Brugada-2 pattern is only suggestive of the possibility of Brugada Syndrome, and it is in no way by itself diagnostic. THANKS again for your positive feedback! - :)

  • @davidlu9926

    @davidlu9926

    3 жыл бұрын

    Thank you for your answer and detailed response Dr. Grauer! It is greatly appreciated. Just to clarify your answer, I read on Dr. Smith’s ECG Blog, that once the brugada saddleback morphology is fulfilled in V1 and/or V2, that in order to confirm a brugada type 2 pattern in its entirety, there “should be, in lead V2” - to quote Dr. Smith: 1. High take-off of the descending limb of the r' at least 2 mm above the isoelectric line (in our case, it is greater than 2 mm). The r'-wave is thus not distinct, as it is in benign causes of rSr' 2. Mismatch between QRS duration in leads V1 and V6 (longer in lead V1). This helps to distinguish from RBBB, in which the QRS duration is equal in V1 and V6. 3. As with Type 1, the peak of the r'-wave does not correspond to the J-point in other leads. 4. The base of the triangle outlined should be longer than 3.5 mm. This confirms that the slope of the ST segment is flat enough for the diagnosis. If these morphologies are not present in V2, but a brugada saddleback morphology was present in V1, then is the ECG still suggestive of brugada pattern type 2 in its entirety? My general understanding was that saddleback pattern is more often seen in V2, but if it’s seen in V1, then V2 must also fill that specific criteria for a confirmatory Type 2 pattern, thus requiring more than one lead to confirm BrP Type 2 if the pattern is only seen in lead V1. Thank you for your time and expertise.

  • @picatchouartbraille3379
    @picatchouartbraille3379 Жыл бұрын

    Bonjour docteur. Il y a deux ans, suite à des perfusion d’immunoglobuline sur 3 jours, sans hydratation " ce qui est une faute grave, car les immunoglobulines épaississent le sang, j'ai eu 15 jours apres une autre perfusion sur 5 j avec une bonne hydratation. Gros problème 6 Jours apres? Une grosse détresse respiratoire.3 semaines apres, j'ai un ECG en forme d'aileron de requin. La forme est semblable à votre dessin du Brugada, mais l'ensemble du QRS à disparue, avalé pas l'ischémie selon Pierre Taboulet. Depuis 3 semaines le Cardiologue à qui je demande des explications sut mon ECG queue de requin, a disparue. Il ne veux pas me répondre. J'ai bien l'impression que je me suis choppé un Infarctus? Merci pour votre retour. Patrick Dupré

  • @lilianabaciu1081
    @lilianabaciu10813 жыл бұрын

    waw

  • @adrianbaranchuk7066
    @adrianbaranchuk70668 жыл бұрын

    Great talk. I would like to invite you to talk about this presentation in our Website at www.brugadaphenocopy.com and eventually insert a link. Congratulations!!!! Adrian Baranchuk MD FACC FRCPC

  • @kg-photos4292

    @kg-photos4292

    8 жыл бұрын

    +Adrian Baranchuk - Hi Adrian. So SORRY for my delay in answering your comment (I was traveling and away from email contact). Your Brugada Phenocopy web site looks excellent! What did you have in mind re talking about my presentation? THANKS again for your kind comment - which means a LOT coming from you with all your expertise in this area! - :)