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Brugada Syndrome

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

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Brugada Syndrome

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

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