title: Fever-induced Brugada pattern: how common is it and what does it mean?
abstract: BACKGROUND
  Fever is known to unmask the Brugada pattern on the electrocardiogram (ECG) and trigger ventricular arrhythmias in patients with Brugada syndrome. Genetic studies in selected cases with fever-induced Brugada pattern have identified disease-causing mutations. Thus, "fever-induced Brugada" is a recognized clinical entity. However, its prevalence has not been systematically evaluated.
  
  
  OBJECTIVE
  The purpose of this study was to assess the prevalence of Brugada pattern in consecutive patients with fever.
  
  
  METHODS
  ECGs of patients with fever admitted to the emergency department were evaluated for the presence of Brugada pattern and compared with ECGs of consecutive nonfebrile patients.
  
  
  RESULTS
  ECGs of 402 patients with fever and 909 without were evaluated. Type I Brugada pattern was 20 times more common in the febrile group than in the afebrile group (2% vs. 0.1%, respectively, P = .0001). All patients with fever-induced type I Brugada pattern were asymptomatic and remained so during 30 months of follow-up.
  
  
  CONCLUSIONS
  Type I Brugada pattern is definitively more common among patients with fever, suggesting that asymptomatic Brugada syndrome is more prevalent than previously estimated.
authors.affiliation: Department of Cardiology, Tel-Aviv Sourasky Medical Center and Sackler School of Medicine, Tel-Aviv University, Israel.
authors.forename: Arnon
authors.initials: A
authors.lastname: Adler
authors.forename: Guy
authors.initials: G
authors.lastname: Topaz
authors.forename: Karin
authors.initials: K
authors.lastname: Heller
authors.forename: David
authors.initials: D
authors.lastname: Zeltser
authors.forename: Tami
authors.initials: T
authors.lastname: Ohayon
authors.forename: Uri
authors.initials: U
authors.lastname: Rozovski
authors.forename: Amir
authors.initials: A
authors.lastname: Halkin
authors.forename: Raphael
authors.initials: R
authors.lastname: Rosso
authors.forename: Shay
authors.initials: S
authors.lastname: Ben-Shachar
authors.forename: Charles
authors.initials: C
authors.lastname: Antzelevitch
authors.forename: Sami
authors.initials: S
authors.lastname: Viskin
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D053840:Brugada Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015897:Comorbidity; D005080:Exercise Test; D005260:Female; D005334:Fever / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies
keywords: AIDS; Brugada syndrome; ECG; Fever; Ventricular fibrillation; acquired immunodeficiency syndrome; electrocardiogram