{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T16:50:26Z","timestamp":1771692626812,"version":"3.50.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2013,9,3]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The characteristic ECG of Brugada syndrome (BS) can be masked by complete right bundle-branch block (CRBBB) and exposed by resolution of the block or pharmacological or pacing maneuvers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              The study consisted of 11 patients who had BS and CRBBB. BS was diagnosed before the development of CRBBB, on the resolution of CRBBB, or from new characteristic ST-segment changes that could be attributable to BS. Structural heart diseases were excluded, and coronary spasm was excluded on the basis of a provocation test at catheterization. In 7 patients, BS was diagnosed before the development of CRBBB. BS was diagnosed when CRBBB resolved spontaneously (n=1) or by right ventricular pacing (n=3). The precipitating cause for the spontaneous resolution of CRBBB, however, was not apparent. On repeated ECGs, new additional upward-convex ST-segment elevation was found in V\n              <jats:sub>2<\/jats:sub>\n              or V\n              <jats:sub>3<\/jats:sub>\n              in 3 patients. In 2 patients, new ST-segment elevation was induced by class I\n              <jats:sub>C<\/jats:sub>\n              drugs. The QRS duration was more prolonged in patients with BS and CRBBB compared with age- and sex-matched controls: 170\u00b113 versus 145\u00b115 milliseconds in V\n              <jats:sub>1<\/jats:sub>\n              and 144\u00b119 versus 128\u00b17 milliseconds in V\n              <jats:sub>5<\/jats:sub>\n              (both\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). The amplitude of R in V\n              <jats:sub>1<\/jats:sub>\n              was larger in the BS patients than in the control subjects (\n              <jats:italic>P<\/jats:italic>\n              =0.0323), but that of R\u2032 was similar (\n              <jats:italic>P<\/jats:italic>\n              =0.0560).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>BS can coexist behind CRBBB, and CRBBB can completely mask BS. BS might be demonstrated by relief of CRBBB or by spontaneous or drug-induced ST-segment elevation. The prevalence, mechanism, and clinical significance of a combination of CRBBB and BS are yet to be determined.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.113.003472","type":"journal-article","created":{"date-parts":[[2013,8,1]],"date-time":"2013-08-01T04:45:58Z","timestamp":1375332358000},"page":"1048-1054","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Brugada Syndrome Behind Complete Right Bundle-Branch Block"],"prefix":"10.1161","volume":"128","author":[{"given":"Yoshiyasu","family":"Aizawa","sequence":"first","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seiji","family":"Takatsuki","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motoaki","family":"Sano","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takehiro","family":"Kimura","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhiro","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kotaro","family":"Fukumoto","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoko","family":"Tanimoto","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kojiro","family":"Tanimoto","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsushige","family":"Murata","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Komatsu","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideo","family":"Mitamura","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Ogawa","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshikazu","family":"Funazaki","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. Komatsu); Tachikawa Hospital, Tokyo, Japan (H.M.); International University of Health and Welfare, Mita Hospital, Tokyo, Japan (S.O.); Saiseikai Kawaguchi General Hospital, Saitama, Japan (T.F.); and Division of Research and..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahito","family":"Sato","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Yoshiyasu Aizawa, S.T., M. Sano, T. Kimura, N.N., K. Fukumoto, Y.T., K.T., M.M., K. Fukuda); Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Iwate, Japan (T. 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