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Brugada Syndrome

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Overview of Brugada syndrome, including signs and symptoms, EKG findings, and treatment.

Overview of Brugada syndrome, including signs and symptoms, EKG findings, and treatment.

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  • Polymorphic VT
  • SE Asia- problem has been know for decades. In Thailand, it is called Lai Tai (death during sleep)
  • May be a higher percentage due to unfamiliarity with disease- “you see only what you look for- you recognize only what you know”
  • Causes of EKG variance
  • Confirms diagnosis of Brugada syndrome, and pt can be treated accordingly.
  • Hopefully, more and more will be discovered about this condition, so we can identify the patients at risk and get them the treatment they need.
  • Transcript

    • 1. BRUGADA SYNDROME
      A Brief Overview
    • 2. What is Brugada Syndrome?
      • Genetic abnormality of the cardiac sodium channels, leading to VT and/or SCD
      • 3. Hereditary
      -60% of Brugada patients have a family history of SCD
    • 4.
    • 5. A Few Facts
      • Characteristic EKG
      • 6. Arrhythmias frequently occur during sleep
      • 7. More common in certain ethnic groups
    • How Common is Brugada?
      • Difficult to know, due to recent discovery
      • 8. First described at NASPE meeting in 1991
      • 9. Review of literature estimates that Brugada causes 4-12% of unexpected sudden deaths worldwide
      -Plus up to 50% of SCD in patients with normal hearts
    • 10. Patient Characteristics
      • Relatively young
      • 11. Predominantly male
      • 12. No structural heart disease
    • Common EKG Findings
      • ST elevation in V1-V3
      • 13. Pseudo RBBB
    • Typical Brugada EKG
    • 14. Signs & Symptoms
      • Asymptomatic
      • 15. Syncope- typically due to NSVT
      -Check for family history of SCD
      -Perform PES
      • SCD in otherwise young, healthy patient
    • Signs & Symptoms
      • Characteristic EKG
      -In EKGs that appear normal, AADs can be given to provoke the typical findings
      -for patients with syncope of unknown origin or VF with unknown cause
      -also for patients with family history and first degree heart block in absence of ST elevation
    • 16. AAD in Pts with Normal EKG
    • 17. Treatment
      • Only treatment that reduces risk of SCD is an ICD
      • 18. Drug therapy has not been effective (beta blockers and amiodarone)
    • Indications
      • ICD Recommended
      -Cardiac Arrest (Class I)
      -Documented VT (Class IIa)
      -Spontaneous ST elevation on EKG, and patient has had syncope (Class IIa)
    • 19. HRS Update May 2011
      Risk Stratification and Therapy Selection in Brugada Syndrome- the PRELUDE Registry
      • Is inducible VT an accurate predictor of cardiac events in Brugada patients?
      • 20. Results: VT/VF inducibility is not predictive of cardiac events; however, investigators found new risk indicators for arrhythmic events
    • References
      www.brugada.org
      www.hrsonline.org