Fragmentation in Body Surface Potential Mapping recordings from patients with Brugada syndrome

Brugada syndrome (BrS) causes sudden death in patients with structurally normal hearts. Manifestation of BrS in the ECG is dynamic and most patients do not show unequivocal signs of the syndrome during ECG screening. Fragmentation of QRS complexes in BrS patients has been linked to a worse prognosis and higher risk. In this study we aim to determine the spatial location of fragmented ECG signals in BrS and controls in order to elucidate its potential role in the diagnosis of BrS and the identification of patients with a higher risk. We obtained 67-lead Body Surface Potential Mapping recordings of 38 BrS, 28 Right Bundle Branch Block (RBBB) patients and 16 controls. Fragmentation of QRS complexes appeared in the anterior torso of symptomatic BrS patients with a higher incidence than in asymptomatic individuals. P waves of symptomatic BrS patients were more fragmented than in other groups.