Last reviewed: 5 Oct 2024
Last updated: 19 Mar 2024
Summary
Definition
History and exam
Key diagnostic factors
- past history of unexplained cardiac arrest or documented PMVT or VF
- cardiogenic syncope
Full details
Other diagnostic factors
- inducible features of Brugada syndrome
- atrial arrhythmias
- nocturnal agonal respirations
Full details
Risk factors
- age 30 to 50 years
- male sex
- Asian ancestry
- family history of BrS or suspicious or unexplained cardiac death
Full details
Diagnostic tests
1st tests to order
- ECG
- echocardiogram
Full details
Tests to consider
- provocative drug testing with sodium channel blockade
- genetic testing for BrS
- advanced cardiac imaging (MRI or CT)
- invasive electrophysiological (EP) study with inducibility testing for ventricular arrhythmias
Full details
Treatment algorithm
INITIAL
with acute ventricular arrhythmia
ACUTE
asymptomatic
symptomatic
Contributors
Authors
Eugene H Chung, MD, MPH
Professor of Internal Medicine
Director of Sports Electrophysiology Clinic
Massachusetts General Hospital
Harvard Medical School
Boston
MA
Disclosures
EHC declares that he has no competing interests.
Acknowledgements
Professor Eugene H Chung would like to gratefully acknowledge Dr Mohammed-Ali Jazayeri for his contribution to the initial drafts of this topic.
Disclosures
MAJ declares that he has no competing interests.
Peer reviewers
Sei Iwai, MD
Section Chief, Cardiac Electrophysiology
Department of Cardiology
Westchester Medical Center Health Network
Valhalla
NY
Disclosures
SI declares that he has no competing interests.
Amanda Varnava, MA(Hons), MD, FRCP
Consultant Cardiologist
Imperial College Healthcare Trust
London
UK
Disclosures
AV declares that she has no competing interests.
Differentials
- Acute coronary syndrome
- Arrhythmogenic cardiomyopathy
- Athlete’s heart
More DifferentialsGuidelines
- 2022 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death
- 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death
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