Brugada syndrome: Prognosis, management, and approach to screening
- John V Wylie, MD, FACC
John V Wylie, MD, FACC
- Assistant Professor of Medicine
- Tufts Medical School
- Ann C Garlitski, MD, FACC, FHRS
Ann C Garlitski, MD, FACC, FHRS
- Assistant Professor of Medicine
- Hofstra North Shore-LIJ School of Medicine
- Hofstra University
- Section Editors
- Scott Manaker, MD, PhD
Scott Manaker, MD, PhD
- Section Editor — Critical Care
- Professor of Medicine
- University of Pennsylvania School of Medicine
- Samuel Asirvatham, MD
Samuel Asirvatham, MD
- Section Editor — Long QT Syndrome
- Professor of Medicine and Pediatrics
- Mayo Clinic College of Medicine
The vast majority of cases of sudden cardiac arrest (SCA) and sudden cardiac death (SCD) are caused by ventricular tachyarrhythmias, with most of these associated with structural heart disease, particularly coronary heart disease. SCA in the apparently normal heart is an uncommon occurrence, accounting for only 5 to 10 percent of SCA cases. (See "Pathophysiology and etiology of sudden cardiac arrest".)
Some causes of SCA in patients with apparently normal hearts have been identified and include:
●Congenital long QT syndrome (LQTS) (see "Clinical features of congenital long QT syndrome")
●Acquired LQTS with polymorphic ventricular tachycardia (VT) (see "Acquired long QT syndrome")
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- PROGNOSTIC FACTORS
- History of sudden cardiac arrest or syncope
- Atrial fibrillation
- Other risk markers
- Asymptomatic patients
- Symptomatic patients with Brugada syndrome
- - Our approach to treatment
- - ICD therapy
- - Drug therapy
- Medications to avoid
- - Catheter ablation
- Complications of therapy
- Asymptomatic patients with the Brugada ECG pattern
- Recommendations of others
- SCREENING OF FIRST-DEGREE RELATIVES
- Positive screening results
- Negative screening results
- Indeterminate screening results
- Frequency of repeat screening
- SUMMARY AND RECOMMENDATIONS