title: Specificity of elevated intercostal space ECG recording for the type 1 Brugada ECG pattern.
abstract: BACKGROUND
  Right precordial (V1-3) elevated electrode placement ECG (EEP-ECG) is often used in the diagnosis of Brugada syndrome (BrS). However, the specificity of this has only been studied in smaller studies in Asian populations. We aimed to study this in a larger European population.
  
  
  METHODS
  Two different populations consisting of healthy subjects were used. A total of 340 subjects were included, 80% were men, the median age was 43 year (interquartile range: 31-51) and all were of European ethnicity.
  
  
  RESULTS
  No type 1 ECG patterns were identified but 16 (4.7%) subjects with a type 2 ECG and 32 (9.4%) subjects with a type 3 ECG were identified in any lead placement. In total 43 (13%) subjects had any BrS ECG pattern in any lead placement. The specificity was 100% (one-sided 97.5% CI: 99%) for the use of EEP-ECG to uncover type 1 pattern. For type 2 pattern the specificity was 95% (95% CI: 92-97%) and for type 3 pattern 91% (95% CI: 88-94%).
  
  
  CONCLUSIONS
  Elevated electrode placement ECG in the diagnosis of BrS seems to have a very high specificity with regards to the finding of a type 1 ECG pattern in a European population; conversely a finding of a type 2 or 3 pattern is of a significantly lower specificity and should perhaps be disregarded.
authors.affiliation: The Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark. anders@kanten.dk
authors.forename: Anders G
authors.initials: AG
authors.lastname: Holst
authors.forename: Mogens
authors.initials: M
authors.lastname: Tangø
authors.forename: Velislav
authors.initials: V
authors.lastname: Batchvarov
authors.forename: Malini
authors.initials: M
authors.lastname: Govindan
authors.forename: Stig
authors.initials: S
authors.lastname: Haunsø
authors.forename: Jesper H
authors.initials: JH
authors.lastname: Svendsen
authors.forename: Elijah R
authors.initials: ER
authors.lastname: Behr
authors.forename: Jacob
authors.initials: J
authors.lastname: Tfelt-Hansen
mesh_terms: D000328:Adult; D053840:Brugada Syndrome / Q000453:epidemiology / Q000503:physiopathology*; D016009:Chi-Square Distribution; D003718:Denmark / Q000453:epidemiology; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D044465:White People