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Brugada syndrome

Last reviewed: 12 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.

  • Brugada syndrome images
  • Differentials

    • Acute coronary syndrome
    • Arrhythmogenic cardiomyopathy
    • Athlete’s heart
    More Differentials
  • Guidelines

    • 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
    More Guidelines
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