This document discusses Brugada syndrome, which is characterized by ST segment elevation in leads V1 to V3 of the ECG. It typically presents in patients in their third or fourth decade and can cause syncope due to tachyarrhythmia, especially during sleep or rest. Treatment involves implanting an ICD for patients who have experienced cardiac arrest, while quinidine may be used if ICD is not possible or to reduce ICD shocks. Brugada syndrome has a genetic component and similar ECG patterns can be seen in other conditions.

1. ‫الرحیم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬

2. Definition and Treatment

3.  It is characterized by ST segment elevation (::::::2 mm) in right pre-cordial leads (V I to V
3) followed by inverted T waves, incomplete or complete right bundle branch block, and
susceptibility to ventricular tachyarrhythmia (particularly polymorphic ventricular
tachycardia) and sudden cardiac death.
 Syncope due to tachyarrhythmia usually occurs during sleep or at rest.
 Typically presents in third or fourth decade.
 Similar ECG patterns are seen in anterior wall infarction, arrhythmogenic right ventricular
dysplasia, acute pericarditis, Duchenne muscular dystrophy, hypercalcemia and
hyperkaliemia.
 Genetically transmitted as an autosomal dominant syndrome with incomplete penetrance.
 Treatment involves implantable cardioverter defibrillator (ICD) in patients who have
experienced at least one attack of cardiac arrest. Quinidine may be used if ICD
implantation is not feasible. It can also be used along with ICD to reduce number of
shocks delivered by ICD.