Type 1 Brugada pattern electrocardiogram induced by hypokalemia

Abstract

Coved-type ST-segment elevation in the right precordial leads are the characteristics of Brugada syndrome, an inherited arrhythmogenic ion channel disease, which could lead to ventricular arrhythmia and sudden death. Hypokalemia alone may induce Type 1 Brugada pattern electrocardiogram (EKG), and the association has rarely been reported. We describe a patient with hypokalemia 2.9 mmol/L and the appearance of new right bundle branch block pattern with coved ST-segment elevations with inverted T wave in leads V1-V2. Serum potassium was corrected and repeated EKG 6 h later revealed disappearance of Type 1 Brugada pattern. Although there is no definite value of serum potassium level that can induce Brugada pattern EKG, hypokalemia may unmask Type 1 Brugada EKG pattern. Awareness of its appearance should be made by all physicians since patients with a family history of arrhythmia or sudden cardiac death (SCD) are at the high risk of developing SCD.

Keywords

• Brugada syndrome
• hypokalemia
• sudden cardiac death