The 12 Leads of Christmas: V1

This article is the seventh in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. Happy New Year everyone! Today’s post is going to be a bit of a hodge-podge as I recover from yesterday’s post on ST-elevation in aVR. Let’s talk about V1! Brugada Syndrome Like yesterday’s topic, we’ve reached the point where it seems like almost too many people are now aware of Brugada syndrome. It’s not an problem to have more people aware of a deadly disease but it does become an issue when the general understanding of the topic becomes muddled. At present there is a lot of confusion over: What is required to diagnose a patient with Brugada syndrome? What is the significance of the three right-precordial ST-patterns originally described? What role do 2nd and 3rd ICS electrode placement have in the diagnosis? Do patients need a history of syncope, sudden death, or documented ventricular arrhythmias to qualify for the diagnosis? What do I do with the patient who is asymptomatic but shows a spontaneous Brugada-type pattern? What do I do with the patient who is febrile or on a sodium channel blocker and shows a type I pattern without documented syncope or ventricular arrhythmias? I also see a lot of people who think every RBBB or incomplete-RBBB they come across is diagnostic of Brugada syndrome and that’s just silly. There are several different consensus guidelin...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: 12-Leads of Christmas Original Articles Uncategorized Vince DiGiulio Source Type: research