title: Prevalence of the type 1 Brugada electrocardiogram in Caucasian patients with suspected coronary spasm.
abstract: OBJECTIVE
  Sporadic cases have reported the coexistence of coronary spasm and Brugada syndrome. However, the prevalence of the Brugada phenotype in coronary spasm is unknown, particularly in non-Japanese populations. In this study, we sought to examine the prevalence of the type 1 Brugada electrocardiogram (ECG) in a large European patient population undergoing intracoronary provocation testing for suspected coronary spasm.
  
  
  RESULTS
  We retrospectively evaluated ECG data for the presence of type 1, 2, and 3 Brugada ECGs from 955 consecutive German patients without obstructive coronary artery disease undergoing intracoronary acetylcholine (ACH) provocation (ACH-test). Eight hundred and twenty-seven patients (age 63 ± 12 years; 42% male) with complete ECG data were eligible for further analysis. The ACH-test revealed coronary spasm in 325 patients (39.3%). A Brugada ECG of any type was found in six patients (0.7%) at baseline and eight patients (0.9%) at any time. There was no difference in the prevalence of coronary spasm in patients with (37.5%) and without (39.3%) Brugada-type ECGs. The type 1 Brugada ECG was not seen at baseline, but two type 1 Brugada ECGs were observed during ACH-administration into the right coronary artery (RCA; 0.2%), one with simultaneous RCA spasm and one without. Ajmaline provocation testing reproduced the type-1 Brugada ECG in the patient without coronary spasm but she had no other features of the Brugada syndrome.
  
  
  CONCLUSIONS
  This study reports a low prevalence of the type 1 Brugada ECG in the largest known European collection of intracoronary ACH provocation. In these patients, we found no evidence for the coexistence of Brugada syndrome and coronary spasm. This is in contrast to available Japanese data.
authors.affiliation: Department of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Ong
authors.forename: Rachel
authors.initials: R
authors.lastname: Bastiaenen
authors.forename: Velislav N
authors.initials: VN
authors.lastname: Batchvarov
authors.forename: Anastasios
authors.initials: A
authors.lastname: Athanasiadis
authors.forename: Hariharan
authors.initials: H
authors.lastname: Raju
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Kaski
authors.forename: Udo
authors.initials: U
authors.lastname: Sechtem
authors.forename: Elijah R
authors.initials: ER
authors.lastname: Behr
mesh_terms: D000109:Acetylcholine / Q000494:pharmacology; D000368:Aged; D000404:Ajmaline / Q000494:pharmacology; D000889:Anti-Arrhythmia Agents / Q000494:pharmacology; D044466:Asian People / Q000208:ethnology; D053840:Brugada Syndrome / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology*; D015897:Comorbidity; D003329:Coronary Vasospasm / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology*; D003331:Coronary Vessels / Q000187:drug effects; D004562:Electrocardiography; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014665:Vasodilator Agents / Q000494:pharmacology; D044465:White People / Q000208:ethnology*
chemical_list: D000889:Anti-Arrhythmia Agents; D014665:Vasodilator Agents; D000404:Ajmaline; D000109:Acetylcholine