Brugada syndrome has three distinct type of ECG pattern.ST segment in V1 to V3 shows the maximal changes .All manifest as subtle forms of ST elevation .
This is an ECG of a young male who was suspected to have CAD with an abnormal ECG .(Which was Infact Brugada . )
He was adviced EST by a physician .Compare the leads V1 to V3 pre and post exercise
Prompt normalization indicate correction of repolarization heterogeneity and suggest relative immunity for development of ventricular arrhythmia at fast rates.
In contrary , new appearance or worsening of Brugada pattern would help us identify high risk subsets of Brugada.
Message : We have sophisticated genetic and EP studies available EST is a simple test to risk stratify these individuals.( Not a perfect screening test though !)