Editorial commentary: Brugada syndrome or not? That is the question

Bassil, Guillaume; Noujaim, Sami F.

doi:10.1016/j.tcm.2017.12.010

Cited by 1 publication

(1 citation statement)

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“…With the discovery of radiofrequency ablation therapy, there is now an alternative therapy option in addition to ICD placement and quinidine that can help to treat high-risk patients without the unintended complication of ICD. However, more research still needs to be done to better fine-tune and diversify therapeutic options for different patients, whether it be searching for novel I to blockers (similar to quinidine) that work as both an anti-arrhythmic and a modulator of the sympathovagal balance, discovering upstream therapy with remodelling preventing agents, perfecting standardised ablation procedures, or a combination of them all [117].…”

Section: Future Directionmentioning

confidence: 99%

Brugada syndrome

Korlipara¹,

Korlipara

Pentyala³

2020

Acta Cardiologica

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Brugada syndrome (BrS) is an inherited cardiac arrhythmia syndrome that causes a heightened risk for ventricular tachyarrhythmias and sudden cardiac death. BrS is characterised by a coved ST-segment elevation in right precordial leads. The prevalence is estimated to range between 1 in 5,000 to 1 in 2,000 in different populations, with the highest being in Southeast Asia and in males. More than 18 genes associated with BrS have been discovered and recent evidence has suggested a complex polygenic mode of inheritance with multiple common and rare genetic variants acting in concert to produce the BrS phenotype. Diagnosis of BrS in patients currently relies on presentation with a type-1 Brugada pattern on ECG either spontaneously or following a drug provocation test using a sodium channel blocker. Risk assessment in patients diagnosed with BrS is controversial, especially with regard to the predictive value of programmed electrical stimulation and novel ECG parameters, such as QRS fragmentation. The first line of BrS therapy remains an implantable cardioverter defibrillator (ICD), although radiofrequency catheter ablation has been shown to be an effective option in patients with contraindications for an ICD. True BrS can be unmasked on ECG in susceptible individuals by monitoring factors such as fever, and this has been recently evident in several patients infected with the 2019 novel coronavirus (COVID-19). Aggressive antipyretic therapy and regular ECG monitoring until fever resolves are current recommendations to help reduce the arrhythmic risk in these COVID-19 patients. In this review, we summarise the current knowledge on the epidemiology, pathophysiology, genetics, clinical diagnosis, risk stratification and treatment of patients with BrS, with special emphasis on COVID-19 comorbidity.

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Section: Future Directionmentioning

confidence: 99%