Brugada syndrome: manifest, concealed, "asymptomatic," suspected and simulated.

In the 2001 edition of the textbook Heart Disease (1) Brugada syndrome is defined as a “distinct form of idiopathic ventricular fibrillation (VF) in which patients have right bundle branch block (RBBB) and ST elevation in the anterior precordial leads without evidence of structural heart disease.” Although patients with such characteristics were described before the Brugada brothers reported their findings (2), the eponym “Brugada syndrome” is a deserved tribute to these investigators, who were the first to define this syndrome as a distinct functional cardiac disorder (3). The three components of the syndrome are: 1) syncope and sudden cardiac death (SCD); 2) absence of structural heart disease, QT prolongation, and metabolic or pharmacologic factors for triggering cardiac arrest; and 3) complete or incomplete RBBB with elevation of the ST segment or of the J point in the leads V1 to V2 and V3, which will be referred to as Brugada electrocardiogram (ECG) pattern.