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Brugada Syndrome

What is Brugada Syndrome?

Brugada Syndrome is heart condition that can cause abnormal heart rhythms. This condition causes a characteristic pattern on the electrocardiogram (ECG). Brugada syndrome was named after one of the doctors who described this condition.

What causes Brugada Syndrome?

Brugada syndrome is caused by a problem with the genes and can be hereditary. The abnormal gene causes an alteration in the flow of electrical currents in the heart which in turn can cause abnormal heart rhythms. The condition is approximately ten times more common in men than women.

What are the Symptoms of Brugada Syndrome?

Many patients with Brugada Syndrome have no symptoms. However, some patients have abnormal heart rhythms which can lead to a blackout or near blackout, or a cardiac arrest. Rarely, Brugada Syndrome can cause sudden death.

How is Brugada Syndrome Diagnosed?

Brugada syndrome may be suspected if a person has recurrent faints or relative is diagnosed with the condition. Brugada Syndrome is diagnosed on an ECG. The characteristic ECG changes may be present all of the time or may come and go so that only some ECGs are normal. Sometimes the ECG abnormalities are only seen following certain medications such as flecainide or ajmaline or when the affected person has a fever.

Family Screening and Genetic Testing

Brugada Syndrome is caused by a genetic alteration and may be inherited. The inheritance pattern is autosomal dominant, which means that there may be more than 1 affected person in each family. All first-degree relatives (parents, siblings and children) of patients with Brugada Syndrome should be checked for the condition. Children of affected parents have a 1 in 2, or 50% chance, of inheriting the condition.

Genetic testing involves a blood test to determine the genetic alteration in an individual (different families might have different genetic alterations). Currently, genetic testing is able to identify the cause of Brugada Syndrome in approximately 15-20% patients. A positive genetic test can be used to help diagnose the condition in family members.

Treatment and Lifestyle Modifications

There is currently no treatment to “cure” the disease. Persons who have Brugada syndrome and have faints may have a defibrillator implanted. Some patients will be prescribed a medication called quinidine. Certain lifestyle modifications are recommended to reduce the risk of triggering abnormal heart rhythm disturbances. Fever of greater than 38 degrees should be treated with paracetamol (Panadol). Alcohol binges should be avoided. Intense (competitive) exercise should be avoided, and light-moderate intensity exercise is encouraged. Certain drugs need to be avoided. A list of these can be found on www.brugadadrugs.org. It is advisable to notify your pharmacist of your condition before taking any prescribed or over the counter medication.

What is the Outlook of People with Brugada Syndrome?

The vast majority of those with Brugada Syndrome will lead normal and productive lives with a good quality of life. The risk of death is low in those receiving appropriate treatment.

© Drs Caroline Medi and Mark McGuire Version 1.2 (5/1/16)

More info: Safe use of medications in Brugada Syndrome (maintained by Brugada Specialists)