title: Criteria for evaluating rSr' patterns due to high precordial ECG lead placement accurately confirm absence of a Brugada ECG pattern.
abstract: BACKGROUND
  An rSr' pattern in leads V1-V2 can be observed when ECG leads are placed in the 2nd intercostal space. Recently, three criteria analyzing the ST segment and r' width to identify true Brugada pattern ECGs have been described.
  
  
  OBJECTIVE
  To assess the feasibility and reliability of using high precordial lead ECGs in conjunction with three new criteria for identifying true Brugada pattern ECGs.
  
  
  METHODS
  ECGs of 491 college athletes and 181 non-athletes were performed with standard and high-lead ECGs. ECGs were then analyzed using the newly proposed criteria.
  
  
  RESULTS
  Zero patients had a Brugada type 1 or 2 pattern at baseline; 76 patients demonstrated an rSr' pattern in leads V1-V2 on the high-lead ECG. Two of the 76 (3%) met criteria suggesting a true Brugada ECG.
  
  
  CONCLUSIONS
  New ECG criteria based on the r' wave accurately identify rSr' patterns in V1-V2 from potential Brugada type 2 patterns in patients with purposely placed high precordial leads.
authors: Department of Medicine/Pediatrics, 260 MacNider Building, CB# 7220 UNC School of Medicine Chapel Hill, NC. Electronic address: dperitz@unch.unc.edu.
authors: David C
authors: DC
authors: Peritz
authors: Division of Cardiology, Department of Medicine, UNC-Chapel Hill, 160 Dental Circle, CB 7075, Chapel Hill, NC, USA. Electronic address: ehchung@med.unc.edu.
authors: Eugene H
authors: EH
authors: Chung
mesh_terms: D000328:Adult; D056352:Athletes / Q000706:statistics & numerical data*; D053840:Brugada Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods* / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D010363:Pattern Recognition, Automated / Q000379:methods*; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity
keywords: Arrhythmia; Athletes; Brugada syndrome; ECG; High precordial lead; Sudden death