Brugada syndrome: epidemiology, diagnosis, and management

Enrika Mačiulaitytė1, Eglė Ignatavičiūtė1, Jolanta Laukaitienė2

1Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania

2Hospital of Lithuanian University of Health Sciences Kauno klinikos, Department of Cardiology, Kaunas, Lithuania


Background. Brugada syndrome (BrS) is a rare pathology characterized by ST segment elevation in the right precordial leads in the absence of established structural heart disease. BrS is potentially life-threatening due to the increased risk of ventricular tachyarrhythmias and sudden cardiac death.

Aim: to review the epidemiology, diagnostics, risk stratification, and management of Brugada syndrome.

Methods. The literature used for this review was selected using “Google Scholar” and “Pubmed” databases. The search was performed using the following keywords and their combinations: “Brugada syndrome”, “sudden cardiac arrest”, “arrhythmias”, “epidemiology”, “diagnosis”, “management”.

Results. BrS usually occurs in middle-aged men, with a global prevalence of 0.5 per 1000 population. BrS should be suspected in individuals with ventricular tachyarrhythmias, cardiac arrest, or a positive family history of sudden cardiac death and 1 of 3 characteristic electrocardiographic (ECG) criteria. Currently, it is recommended to limit genetic analysis to the predominant gene (SCN5A). Assessing the risk of ventricular fibrillation and sudden cardiac death remains the main challenge. Although cardioverter-defibrillator (ICD) implantation remains the first-choice treatment for high-risk patients, drug treatment with quinidine, and radiofrequency ablation (RDA) also effectively reduce the risk of arrhythmias (respectively, 90% and 87%).

Conclusions. BrS is a rare pathology, more common in Southeast Asia. BrS is diagnosed by spontaneous or drug-induced ECG changes, although in clinical practice, symptoms or a positive family history are also important. Risk assessment in BrS patients remains challenging. The main treatment methods for BrS patients are ICD implantation, medical treatment, and RDA.

Keywords: Brugada syndrome, sudden cardiac arrest, arrhythmias.

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