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Risk Stratification and Treatment of Brugada Syndrome

  • Invasive Electrophysiology and Pacing (EK Heist, Section Editor)
  • Published:
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Abstract

The Brugada syndrome (BS) is a hereditary disease characterized by typical electrocardiographic alterations (elevation of the ST segment in right precordial leads) that affects young individuals without structural heart disease, predisposing them to ventricular arrhythmias and sudden death (SD). Several genetic mutations of different subunits of the sodium, calcium and potassium channel have been involved. The majority of patients with BS remain asymptomatic; however, the most frequent symptoms are syncope and/or SD secondary to polymorphic ventricular tachycardia (PVT) or ventricular fibrillation (VF). Electrocardiographic manifestations of the BS are typically dynamic and occasionally only become apparent after the administration of a sodium channel blocker or with fever. Risk stratification is mainly based on symptoms and the surface electrocardiogram. However, in asymptomatic patients, risk evaluation is still controversial and requires further studies. This review provides an updated summary of the BS from the point of view of genetic, clinical manifestations, risk stratification and management.

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Abbreviations

BS:

Brugada syndrome

ECG:

Electrocardiogram

EPS:

Electrophysiological study

ICD:

Implantable cardioverter defibrillator

PVT:

Polymorphic ventricular tachycardia

SD:

Sudden death

VF:

Ventricular fibrillation

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Elena Arbelo and Josep Brugada declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Arrhythmia Section, Cardiology Department, Thorax Institute, Hospital Clinic, C/Villarroel 170, 6° Planta – Escalera 3, 08036, Barcelona, Spain

    Elena Arbelo & Josep Brugada

  2. Universitat de Barcelona, C/ Casanova 143, 08036, Barcelona, Spain

    Elena Arbelo & Josep Brugada

  3. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Spain

    Elena Arbelo & Josep Brugada

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  1. Elena Arbelo
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  2. Josep Brugada
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Correspondence to Elena Arbelo.

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This article is part of the Topical Collection on Invasive Electrophysiology and Pacing

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Arbelo, E., Brugada, J. Risk Stratification and Treatment of Brugada Syndrome. Curr Cardiol Rep 16, 508 (2014). https://doi.org/10.1007/s11886-014-0508-1

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  • DOI: https://doi.org/10.1007/s11886-014-0508-1

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