title: Unmasking Brugada-type electrocardiogram on deep inspiration.
abstract: BACKGROUND
  Electrocardiogram (ECG) recorded at the upper intercostal lead positions is recommended as an additional diagnostic clue for Brugada syndrome (BrS), but similar recording conditions to unmask ECG signs have not been explored.
  
  
  RESULTS
  We evaluated the diagnostic usefulness for unmasking ECG signs of BrS using recordings at the upper intercostal lead position, on deep inspiration and on standing. In 34 patients (mean age, 49±14 years; 30 male) with diagnosed and suspected BrS, ECG type and ST-elevation in leads V1-V3 recorded at a higher position by 1 rib from the standard position (3ICS), and at standard lead positions (4ICS) on deep inspiration (DI test) and on standing (Stand test) were compared with the conventional lead positions (baseline). While type 1 ECG had been documented in 17 of 34 patients on at least 1 occasion in the past, only 4 had the sign at baseline during the study. Twenty patients had type 1 on 3ICS recording, 18 on DI test, and 6 on Stand test. Among 17 patients without previous documentation of spontaneous type 1, 7 had type 1 on 3ICS recording, 6 on DI test, and 1 on Stand test.
  
  
  CONCLUSIONS
  ECG recording on deep inspiration is useful to unmask diagnostic signs of BrS and has similar accuracy to 3ICS recording.
authors.affiliation: Department of Cardiology, Yokohama Minami Kyosai Hospital.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Yamawake
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Nishizaki
authors.forename: Masato
authors.initials: M
authors.lastname: Shimizu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujii
authors.forename: Harumizu
authors.initials: H
authors.lastname: Sakurada
authors.forename: Masayasu
authors.initials: M
authors.lastname: Hiraoka
mesh_terms: D000328:Adult; D053840:Brugada Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D001239:Inhalation; D008297:Male; D008875:Middle Aged; D011187:Posture