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Ecg changes can be transient with brugada syndrome and can also be unmasked or augmented by multiple factors The st segment represents the interval between ventricular depolarization and repolarization. This is the only ecg abnormality that is potentially diagnostic

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It is often referred to as brugada sign. The st segment is the flat, isoelectric section of the ecg between the end of the s wave (the j point) and the beginning of the t wave Pragmatically, only a type 1 pattern is diagnostic for brugada syndrome, whereas patients with type 2/3 patterns should undergo sodium channel blocker provocation testing.

This pattern was described by brugada brothers in 1992, it is characterized by a prominent coved st segment or j point elevation ≥2 mm (0.2 mv) followed by a negative t wave in at least one right precordial lead (v1 or v2), which are placed in a standard or a superior position.

This pattern was initially thought to be suggestive of brugada syndrome, but is no longer considered suggestive of brugada syndrome, but is now thought to be a normal variant.