Inherited arrhythmias

Shanghai Brugada Score

Supports the diagnostic assessment of suspected Brugada syndrome using ECG findings, clinical history, family history and genetic testing.

Scoring rule

Select one option from each section. Only the highest applicable finding within a category is scored. At least one qualifying ECG finding is required.

Diagnostic variables

Select applicable findings

ECG findings

Required

One ECG option must apply for a valid classification.

Clinical history

Select the single highest applicable clinical-history item.

Family history

Consider first- and second-degree relatives.

Genetic test result

Variant interpretation should follow current clinical genetics standards.

Diagnostic categories

Nondiagnostic

<2 points

Below the proposed diagnostic threshold.

Possible Brugada syndrome

2–3 points

Additional assessment may be needed.

Probable or definite

≥3.5 points

Meets the proposed Shanghai threshold.

Important clinical limitations

The Shanghai score is a diagnostic support system, not an independent treatment or ICD-decision score.

Brugada phenocopies and alternative causes of right precordial ST-segment elevation should be excluded, including ischemia, electrolyte disturbances, mechanical compression and medication effects.

Drug-provocation testing should be performed only under an appropriate specialist protocol with continuous monitoring and resuscitation facilities.

Genetic variants should not be counted solely because they are reported in a Brugada-associated gene. Formal pathogenicity assessment is required.

References

Antzelevitch C, Yan GX, Ackerman MJ, Borggrefe M, Corrado D, Guo J, Gussak I, Hasdemir C, Horie M, Huikuri H, Ma C, Morita H, Nam GB, Sacher F, Shimizu W, Viskin S, Wilde AA. J-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledge. Heart Rhythm. 2016 Oct;13(10):e295-324. doi: 10.1016/j.hrthm.2016.05.024. Epub 2016 Jul 13. PMID: 27423412; PMCID: PMC5035208.

Kawada S, Morita H, Antzelevitch C, Morimoto Y, Nakagawa K, Watanabe A, Nishii N, Nakamura K, Ito H. Shanghai Score System for Diagnosis of Brugada Syndrome: Validation of the Score System and System and Reclassification of the Patients. JACC Clin Electrophysiol. 2018 Jun;4(6):724-730. doi: 10.1016/j.jacep.2018.02.009. Epub 2018 Mar 28. PMID: 29929664.

This calculator provides clinical decision support and does not replace specialist ECG interpretation, exclusion of phenocopies, genetic counseling or individualized arrhythmic-risk assessment.