Vitali F, Brieda A, Balla C, et al. - By conducting a systematic review of the literature, researchers analyzed the spectrum of ECG signs related to negative prognosis in Brugada syndrome (BrS) in order to determine the incremental risk of each sign as well as to unveil the electrogenetic and pathophysiologic mechanisms underlying the different ECG characteristics. The literature search yielded 29 eligible articles consisting of a total of 5,731 patients. Localization of type 1 Brugada pattern (in V2 and peripheral leads), first‐degree atrioventricular block, atrial fibrillation, fragmented QRS, QRS duration > 120 ms, R wave in lead aVR, S wave in L1 (≥ 40 ms, amplitude ≥ 0.1 mV, area ≥ 1 mm ² ), early repolarization pattern in inferolateral leads, ST‐segment depression, T‐wave alternans, dispersion of repolarization, and Tzou criteria, all were revealed as ECG findings related to an incremental risk of syncope, sudden death, or equivalents (hazard ratio ranging from 1.1–39). Overall, a higher risk of sudden death in BrS was observed in relation to at least 12 features of standard ECG. Current risk stratification scores of patients with BrS could be improved via a multiparametric risk evaluation strategy based on ECG parameters related to clinical and genetic findings.