Brugada Syndrome: A Clinical Review

Authors

Alex Lower PA-C, University of LynchburgFollow

Specialty

Emergency Medicine

Advisor

Dr. Tom Colletti, DHSc, PA-C, DFAAPA; Jenna Rolfs, DMSc, PA-C; Jaqueline Perdue, DMSc, PA-C

Abstract

Purpose: The purpose of this article is to review the essentials, epidemiology, pathophysiology, common presentation, diagnosis, and treatment of Brugada syndrome (BrS).

Method: A PubMed and ProQuest literature search was conducted with the search terms Brugada Syndrome. Ten pertinent articles were retrieved and served as the basis for this clinical review.

Results: The diagnostic approach and treatment recommendations continue to evolve in BrS. The primary tool for diagnosis is the changes appreciated on the patient’s electrocardiogram (ECG). Type 1 Brugada syndrome, also known as the coved type, is defined as an ST-elevation of greater than or equal to 2 millimeters among the V1 – V2/V3 precordial leads on ECG with associated T-wave inversion. The prior mainstay of therapy for BrS has been an implanted cardioverter defibrillator (ICD) with long-term follow-up. However, recent advances have determined that this dysrhythmia originates in the right ventricular outflow tract (RVOT) and that radiofrequency ablation can decrease the number of appropriate ICD shocks and symptoms.

Conclusion: Brugada syndrome is a rare inherited dysrhythmia that predisposes patients to sudden cardiac death due to ventricular fibrillation. The most common genetic mutation associated is SCN5A, which is present in about 30% of patients diagnosed with BrS. BrS most commonly affects males of Asian descent. Pharmacologic therapy, ICD implantation, and radiofrequency ablation is the recommended treatment. Further research is needed to determine the prevalence of BrS in asymptomatic patients and other associated genetic abnormalities.

Recommended Citation

Lower A. Brugada Syndrome: A Clinical Review. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2022; 4(3).