Scenario: This is a 12-lead ECG from a 74-year-old Japanese man presenting to the coronary care unit for treatment of symptomatic atrial fibrillation. The patient’s cardiac rhythm fluctuates between atrial fibrillation and sinus rhythm. The patient has a history of Brugada syndrome, which was diagnosed 15 years earlier. Currently, the patient is asymptomatic with normal vital signs.

Sinus bradycardia at 53/min, with J point (end of the QRS and beginning of the T wave) elevation in lead V2 suggestive of type 1 Brugada syndrome

Brugada syndrome is a familial genetic disease of the sodium channel of the heart that is more prevalent in persons from Southeast Asia. Brugada syndrome is responsible for roughly 20% of sudden cardiac deaths (SCDs), striking in the prime of life (41±5 years). ECG abnormalities are its hallmark, and ECG features can be dynamic...

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