Prevalence of Brugada-type ECG pattern and early ventricular repolarization pattern in Tunisian athletes

Sana Ouali¹, Helmi Ben Salem¹, Sami Hammas¹, Elyes Neffeti¹, Fahmi Remedi¹, Abdallah Mahdhaoui², Essia Boughzela¹, Rafik Mankai^3
1Department of Cardiology, Sahloul Hospital, Sousse, Tunisia; ²Department of Cardiology, Farhat Hached, Sousse, Tunisia; ³Central Sports Medicine Centre of El Menzah, Tunisia

Introduction: No data regarding the prevalence of the Brugada-type electrocardiogram (ECG) pattern and the early ventricular repolarization pattern (ERP) in the North African population were available. The aims of this study were to determine the frequency of Brugada-type ECG pattern and ERP in Tunisia and to evaluate ECG descriptors of ventricular repolarization in a population of athletes.
Methods: Over a 2-year period, resting 12-lead ECG recordings were analyzed from athletes (n = 540; 348 males; age 18.3 ± 2.4 years). Brugada-type ECG pattern was defined as Type 1, 2, or 3, and ERP was characterized by an elevation of the J point in the inferior and/or lateral leads. The population was divided into three groups of athletes: ERP group; Brugada-type ECG pattern group; and control group, with neither ERP nor Brugada ECG pattern. Clinical and electrocardiographic parameters were compared among the study groups.
Results: Nine subjects (1.66%) had a Brugada-type ECG pattern. None of them had the coved-type, 3 (0.6%) had the Type 2, and 6 (1.1%) had the Type 3. All subjects were asymptomatic. A Brugada-type ECG pattern was observed in seven males. No female had the Type 2 Brugada ECG pattern. ECG parameters were similar among Brugada-type ECG pattern and control athletes. ERP (119 subjects, 22%) was obtained in 98 males. Heart rate was lower, the QRS duration shorter and QT and T_peak–T_end intervals were longer in ERP than control groups.
Conclusion: The results indicate that the frequency of the Brugada-type ECG pattern and ERP were respectively 1.66% and 22.00% in athletes, being more prevalent in males. The ERP group experienced shorter QRS duration and longer T_peak–T_end interval than in the control population.

Keywords: J wave, ERP athletes, T wave