in a superior intercostal space in individuals with high clinical suspicion (aborted sudden cardiac death victims, family members of patients with Brugada syndrome) may also disclose the presence of the arrhythmic substrate. 9 In select cases one may even consider rightward displacement. However, the r deflection in leads V3R, V4R, etc, should be interpreted with caution. Characteristic ECG morphologies recorded in the first few hours after resuscitation or immediately after DC shock cannot be taken as diagnostic of the Brugada syndrome. As shown in Figure 1, the ST segment is dynamic. Different patterns may be observed sequentially in the same patient or following the introduction of specific drugs (see below).

The QT-interval is often within normal limits (in the absence of anti-arrhythmic drug therapy), but it may be prolonged. In the initial series described by Brugada and Brugada, 2 3 out of 6 males had a QTc 440 ms. In male Thai patients with RBBB and ST-elevation, mean QTc was slightly longer than normal. 10 Families with (drug-induced) ST-segment elevation and QT prolongation have also been