Brugada syndrome: new concepts and algorithms in management (RCD code: V 1A.1)

Abstract

Clinical manifestation of Brugada syndrome (BrS) mainly results from polymorphic ventricular arrhythmias and includes sudden cardiac arrest (SCA). The Brugada sign, besides being present in true BrS, may result from different causes. Moreover, electrocardiogram findings in some clinical situations may resemble the BrS electrocardiographic pattern. Thus, differential diagnosis is crucial in the proper management of patients suspected of having BrS. Lifestyle modifications and close follow-up with or without pharmacologic treatment and/or implantable cardioverter-defibrillator placement constitute the most common approach to managing BrS patients. However, the role of ablation in BrS treatment is increasing. Due to diagnostic and therapeutic difficulties, the management of BrS is often challenging. This review provides new concepts and algorithms in the diagnostics and treatment of patients suspected of having BrS. JRCD 2017; 3 (5): 151-160

Pathogenesis and Management of Brugada Syndrome: Recent Advances and Protocol for Umbrella Reviews of Meta-Analyses in Major Arrhythmic Events Risk Stratification

“…The lack of significant structural heart disease in BrS patients may be visualized by echocardiography, angiography, or ventriculography [ 14 , 15 ]. However, magnetic resonance imaging in subgroups of patients with BrS revealed enlarged right ventricular (RV) volumes, increased RV outflow tract (RVOT) area, or mild RV wall motion abnormalities [ 16 ]. The pathomechanism observed in BrS patients involves depolarization and repolarization abnormalities, inflammation of myocytes, and fibrosis in RVOT and/or RV [ 9 , 12 ].…”

Clinical classification of rare cardiac arrhythmogenic and conduction disorders, and rare arrhythmias

“…These included channelopathies: BrS, familial long QT syndrome, familial short QT syndrome, and catecholaminergic polymorphic ventricular tachycardia. [42][43][44][45][46][47][48][49] Moreover, idiopathic ventricular fibrillation and torsades de pointes syndrome with a short coupling interval are also included as major disorders. 50,51 We also included incessant infant ventricular tachycardia in the subgroup of disorders predisposing to ventricular tachyarrhythmias, considering that this clinical entity seems to have a heterogeneous pathogenesis, including histiocytoid cardiomyopathy and cardiac rhabdomyomas.…”