Brugada Syndrome
Brugada Syndrome is an uncommon entity, that can mimic STEMI, has a high rate of sudden cardiac death, and currently ICD placement is the best treatment strategy - Salim Rezaie MD
.jpg)
image by: Rythmologie
HWN Suggests
Electrocardiograms You Need to Know: Brugada Syndrome
BS is a potentially important but not yet well defined entity that should be on the ED radar, but confirming the diagnosis is difficult. Most of the literature regarding this abnormality surfaced within the past seven years or so, making it a new syndrome. Brugada syndrome is one zebra that most EPs have never heard about, don't look for, and like the rest of the world, don't currently understand. Perhaps the takeaway message is to look specifically for an atypical right bundle branch block on the cardiogram, coupled with curiously elevated ST segment in V1-V3, in someone with syncope, palpitations, supraventricular arrhythmias, or after surviving cardiac arrest. If fortuitously noted in the…
Resources
Brugada Syndrome: An ECG Pattern You Need to Know
Brugada Syndrome is an uncommon entity, that can mimic STEMI, has a high rate of sudden cardiac death, and currently ICD placement is the best treatment strategy.
Brugada Syndrome: 3-Step Approach to Diagnosis and Management
ECG interpretation of Brugada pattern: type 1 (coved) is pathognomonic, but type 2 (saddle-back) requires checking lead placement (negative P in V1 or biphasic P in V2 are too high) and measuring the base of the triangle (>4mm measured 5mm from the apex of r’).
ECG Pointers: Syncope and Brugada Syndrome
Even asymptomatic, anyone with an ECG consistent with Brugada’s syndrome has an 8% risk of sudden death over the next 2 years. Implantable defibrillator is the only treatment that has been shown to reduce mortality of Brugada syndrome.
POTD: Brugada Syndrome
Quinidine is the best studied medication for tachyarrhythmias in Brugada, terminating 80% of arrhythmias. (Interestingly it is a Na channel blocker, but it's blockade effect on Ito an outflowing K channel is what helps it treat Brugada). Immediate release form 200-400 mg PO q6h, then extended release 324 mg PO q12. Isoproterenol (B1/B2 agonist) is less studied but it can be given as a drip at 2-10 mcg/min tritrated to effect.
What is Brugada Syndrome?
Brugada Syndrome is an ECG abnormality with a high incidence of sudden death in patients with structurally normal hearts.
Is this Type 2 Brugada syndrome/ECG pattern?
Types 2 and 3 Brugada have been merged into Type 2. The diagnoses have been perplexing for years because they have been based on a "saddleback" morphology. However, saddleback morphology is a very common normal variant: "saddleback" morphology is rarely Brugada pattern and even more rarely Brugada syndrome.
You Gotta Know Brugada
Brugada Pattern EKG is NOT ALWAYS pathalogical. Brugada pattern EKG can be a normal variant, especially in a patient without risk factors, symptoms, and the pattern is an incidental finding during a non-cardiac workup.
Brugada Syndrome: A Look at the “Might Be” and “Maybe” in Diagnosis and Treatment
Currently, implantation of an ICD is the only effective treatment for this syndrome. However, risk stratification of asymptomatic patients with Brugada type ECG is still a challenge.
Classic ECG Pattern
compliments BC Emergency Medicine
Drugs to be avoided by Brugada syndrome patients
The following drugs have been associated with arrhythmias and the typical (type-1) Brugada syndrome ECG. Therefore the BrugadaDrugs.org Advisory Board strongly advices to avoid these drugs in Brugada syndrome patients or to use these drugs only after extensive consideration and/or in controlled conditions.
Management of patients with a Brugada ECG pattern
The correct recognition and management of these patients should be considered an essential skill for any cardiologist. Learn to recognise and treat these patients in six steps.
Electrocardiograms You Need to Know: Brugada Syndrome
Current consensus is that isolated EKG findings are termed “Brugada pattern,” and one must manifest other criteria to garner the moniker of a bona fide Brugada syndrome. The pathology in BS seems to be polymorphic VT that degenerates into VT or cardiac arrest. VT would be obvious, but BS can be silent unless provoked.
BrugadaDrugs.org
BrugadaDrugs.org is a non-profit initiative developed by physicians from the University of Amsterdam Academic Medical Center, department of Cardiology, in collaboration with a panel of world-renowned experts on Brugada syndrome as an aid to physicians who treat patients with Brugada syndrome and as an aid to patients with Brugada syndrome and their families with the goal to provide free, worldwide accessible and up-to-date information on safe drug use in Brugada syndrome.
Core EM
An inherited disorder that predisposes patients to sudden cardiac death by ventricular arrhythmia that is characterized by the following EKG pattern: ST segment elevation with Type 1 Brugada morphology ≥ 2mm in ≥ 1 of the right precordial leads (V1 or V2), spontaneously or after provocative test with intravenous class I anti-arrhythmic medication Type 1 Brugada morphology defined as cove-shaped ST segment elevation ≥ 2mm followed by inverted T wave
ECGpedia.org
The Brugada syndrome is an hereditary disease that is associated with high risk of sudden cardiac death. It is characterized by typical ECG abnormalities: ST segment elevation in the precordial leads (V1 - V3).
Life in the Fastlane
Coved ST segment elevation >2mm in >1 of V1-V3 followed by a negative T wave. This is the only ECG abnormality that is potentially diagnostic. It is often referred to as Brugada sign.
Introducing Stitches!
Your Path to Meaningful Connections in the World of Health and Medicine
Connect, Collaborate, and Engage!
Coming Soon - Stitches, the innovative chat app from the creators of HWN. Join meaningful conversations on health and medical topics. Share text, images, and videos seamlessly. Connect directly within HWN's topic pages and articles.
