Materiały źródłowe

• #1 Brugada syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Brugada_syndrome

  The first line of treatment, suitable for all people with Brugada syndrome regardless of their risk of arrhythmias, is lifestyle advice. People should be advised to recognise and avoid things that may increase the risk of serious arrhythmias. These include avoiding excessive alcohol consumption, avoiding certain medications, and treating fever promptly with paracetamol. […] In people felt to be at higher risk of sudden cardiac death, an implantable cardioverter-defibrillator (ICD) may be recommended. These small devices implanted under the skin continuously monitor the heart rhythm. If the device detects a potentially life-threatening arrhythmia it can give the heart a small electric shock, stunning the heart back into a normal rhythm. […] Quinidine is an antiarrhythmic drug that may reduce the chance of serious abnormal heart rhythms occurring in some people with Brugada syndrome. It is most frequently used in people with Brugada syndrome who have an ICD and have experienced several episodes of life-threatening arrhythmias, but may also be used in people at high risk of arrhythmias but in whom an ICD is not appropriate.

• #1 Brugada syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Brugada_syndrome

  A further treatment option for people with Brugada syndrome is radiofrequency catheter ablation. In this procedure, wires are passed through a vein in the leg into the heart, or through a small hole underneath the sternum. These wires are used to find the area of the heart responsible for initiating the arrhythmias. The tip of one of these wires is used to make a series of tiny burns, intentionally damaging the area of abnormal heart muscle that has been causing the problem. Current recommendations suggest that this treatment should be reserved for those with Brugada syndrome who have had repeated shocks from an ICD.

• #2

• #3 Brugada Syndrome | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/brugada-syndrome-1.html

  Currently, there is no cure for Brugada syndrome. But there are ways to protect people from the dangerous consequences of the disease. An implanted cardioverter defibrillator (ICD) can help prevent sudden death linked to Brugada syndrome. When this device detects the start of an arrhythmia, it will either try to stop it with pacing or deliver a shock to reset it back into its regular rhythm. […] Medicines may also help prevent arrhythmias. Another possible, but rare, treatment choice may be a cardiac ablation. In this procedure, a small area of heart tissue found to cause the dangerous arrhythmia is destroyed. Discuss all choices with a qualified healthcare provider. […] It’s also important to stay away from certain medicines that can make Brugada syndrome worse. […] Many cases of Brugada syndrome are related to a genetic defect. It’s not possible for you to prevent inheriting this condition. But identifying the condition is key to preventing its possible complications. You may first want to talk with a genetic counselor if you have Brugada syndrome and plan to have children.

• #4 The Benefits and Risks of ICD Therapy in Brugada Syndrome

  https://www.thecardiologyadvisor.com/news/the-benefits-and-risks-of-icd-therapy-in-brugada-syndrome/

  Patients with Brugada syndrome that receive ICD therapy have decreased risk for fatal arrhythmias. […] Implantable cardioverter-defibrillator (ICD) therapy is effective for preventing fatal arrhythmias in patients with Brugada syndrome, although device-related complications are common, according to results of a study in JACC: Clinical Electrophysiology. […] Before ICD implantation, physicians should thoroughly explain to Brugada syndrome patients both the potential benefits of the device and the risks associated with device-related complications. […] Before ICD implantation, physicians should thoroughly explain to Brugada syndrome patients both the potential benefits of the device and the risks associated with device-related complications, the investigators wrote.

• #5 Prediction and Prevention of Sudden Death in the Brugada Syndrome – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31586529/

  Sudden cardiac death (SCD) secondary to sudden cardiac arrest (SCA) is a leading cause of death in the United States, claiming over a quarter million lives annually, and is directly responsible for 50% of all cardiovascular mortality. […] In conclusion, accurate identification of high-risk asymptomatic BrS patients (through multiparametric risk scores composed of reliable and validated unambiguous clinical variables and biomarkers) may hold utility in improving current SCD prediction algorithms, and the appropriate primary prevention therapy may prove valuable in reducing risk of sudden death for this patient population.

• #6 “Brugada Syndrome” A Silent and Deadly Threat to Thai Men – Chulalongkorn University

  https://www.chula.ac.th/en/highlight/137610/

  Brugada syndrome, an abnormality in heart rhythm, is one of the major causes of Brugada syndrome. Early treatment and prevention could reduce fatality rate. […] The Brugada syndrome research aims to identify the Genetic predisposition cause of Brugada syndrome, improve prevention and treatment guidelines, and identify factors affecting variation in disease severity in different patients. […] To date, there is no cure for Brugada syndrome. Doctors will provide palliative care to an individual who is diagnosed with the disease including: Cardioverter Defibrillator (ICD) implantation for those who show symptoms. […] Brugada syndrome is not always fatal if you know how to prevent it and receive timely treatment. […] Patients who come for an ECG test and are found to have Brugada Syndrome are unlikely to die, especially when received proper care instructions, so early treatment with medical experts is important.

• #7 Risk stratification of sudden cardiac death in Brugada syndrome: an updated review of literature | The Egyptian Heart Journal | Full Text

  https://tehj.springeropen.com/articles/10.1186/s43044-022-00267-9

  Brugada syndrome is a rare but serious inherited heart disease that causes sudden cardiac death by polymorphic ventricular tachycardia or ventricular fibrillation. […] In this review, we will present the current state of knowledge for arrhythmic risk stratification and the prevention of sudden cardiac death that can result from this syndrome. […] Although not always easy, stratification of the risk of SCD in patients with BrS is required because it has an impact on subsequent management. This stratification takes into account several clinical parameters, electrical history, and programmed ventricular stimulation data. […] In this group of patients, implantation of an implantable cardioverter-defibrillator (ICD) for secondary prevention is necessary without any additional assessment. […] Although not always easy, the differential diagnosis between these two syncope entities is of utmost importance because the implantation of an ICD is only recommended in patients with BrS and presumed arrhythmic syncope given the complications related to the device and its cost.

• #8 Risk stratification of sudden cardiac death in Brugada syndrome: an updated review of literature | The Egyptian Heart Journal | Full Text

  https://tehj.springeropen.com/articles/10.1186/s43044-022-00267-9

  Stratification of the risk of sudden death in asymptomatic cases is essential as it is the basis of patients selection for ICD therapy. […] So that further evaluation for risk factors is needed in order to classify patients as high and low risk for SCD. […] Implantation ICD is only recommended in asymptomatic patients with BrS if they have a spontaneous type 1 pattern of Brugada and a positive EPS (recommendation IIA). […] Risk stratification of sudden death in asymptomatic patients remains a thorny question requiring discussion with competence centers and a personalized indication for ICD implantation.

• #9 Brugada Syndrome Treatment & Management: Approach Considerations, Placement of Implantable Cardioverter-Defibrillator, Activity

  https://emedicine.medscape.com/article/163751-treatment

  To date, the only treatment that has proven effective in treating ventricular tachycardia and fibrillation and preventing sudden death in patients with Brugada syndrome is implantation of an automatic implantable cardiac defibrillator (ICD). […] At present, implantation of an automatic implantable cardioverter-defibrillator (ICD) is the only treatment proved effective in treating ventricular tachycardia and fibrillation and preventing sudden death in patients with Brugada syndrome. […] Patients with Brugada syndrome and a history of cardiac arrest must be treated with an ICD. In contrast, asymptomatic patients with no family history of sudden cardiac death can be managed conservatively with close follow-up, and ICD implantation is not recommended. […] Because regular physical activity may increase vagal tone, sport may eventually enhance the propensity of athletes with Brugada syndrome to have ventricular fibrillation and sudden cardiac death at rest or during recovery after exercise. Accordingly, Pelliccia et al recommended that patients with a definite diagnosis of Brugada syndrome be restricted from participation competitive sports.

• #10 Brugada syndrome: clinical and genetic findings | Genetics in Medicine

  https://www.nature.com/articles/gim201535

  Currently, the ICD is the only effective therapeutic strategy for the prevention of SCD in BrS patients. ICD implantation is a class 1 indication in patients with BrS and a history of either ventricular arrhythmias or aborted SCD. Meanwhile, ICD implantation for an asymptomatic patient with a family history of SCD is class III. […] Despite its effectiveness, the ICD has several disadvantages, including high cost, potential procedural complications at implantation, multiple device replacements, and psychological effects due to high rates of complications, mainly inappropriate shocks. Recently, it has been reported that therapy using new subcutaneous ICDs may be an effective option because it avoids problems associated with the placement of an intravascular lead. […] Another therapeutic option is pharmacological treatment to rebalance ionic currents. Several drugs have been tested, but only isoproterenol and quinidine are recommended as pharmacological options in BrS. Isoproterenol has proven to be useful for treatment of electrical storm in BrS. Quinidine has been shown to prevent VF and suppress spontaneous ventricular arrhythmias. Quinidine is recommended for BrS patients with ICD and multiple shocks when ICD implantation is contraindicated, and for the treatment of supraventricular arrhythmias in the event that other treatments have been contraindicated.

• #10 Brugada syndrome: clinical and genetic findings | Genetics in Medicine

  https://www.nature.com/articles/gim201535

  Finally, radiofrequency catheter ablation has also been postulated as a therapeutic approach in BrS. It has been reported that electrical disconnection of the right ventricular outflow tract can prevent VF inducibility in high-risk populations affected by BrS. Although not free of complications, epicardial ablation has emerged as a potential treatment for BrS.

• #11 Brugada syndrome: A brief review on diagnostic approach, risk stratification, and management – International Journal of the Cardiovascular Academy

  https://ijcva.org/articles/brugada-syndrome-a-brief-review-on-diagnostic-approach-risk-stratification-and-management/doi/IJCA.IJCA_31_18

  Brugada syndrome is a congenital channelopathy in cardiac ion transmembrane causing an alteration in the electrical conduction of the heart. […] Nevertheless, this can be prevented by implantable cardioverter defibrillator implantation. […] ICD implantation is the only effective modality in Brugada syndrome. […] Implantation of ICD is recommended (Class IIa) in a patient with syncope (if syncope is suspected as arrhythmic origin) and spontaneously abnormal ECG (without provocation) because those patients have six times increased risk of cardiac arrest compared to those showing type I ECG after provocation. […] Epicardial ablation is an emerging treatment in the field of Brugada syndrome. […] These findings may usher a new era in treating Brugada syndrome, and the possibility of epicardial ablation being a first-line treatment in the future cannot be overruled.

• #12 Brugada Syndrome Guidelines: Guidelines Summary

  https://emedicine.medscape.com/article/163751-guidelines

  Lifestyle changes: […] Avoidance of drugs that may induce ST-segment elevation in right precordial leads […] Avoidance of excessive alcohol intake and large meals […] Prompt treatment of any fever with antipyretic drugs. […] ICD implantation in patients who are survivors of an aborted cardiac arrest and/or have documented spontaneous sustained ventricular tachycardia (VT). […] Consider ICD in patients with a spontaneous diagnostic type I ECG pattern and history of syncope. […] Consider quinidine or isoproterenol to treat electrical storms. […] Consider quinidine for patients who qualify for an ICD but present a contraindication or refuse it and in patients who require treatment for supraventricular arrhythmias. […] Consider ICD in patients who develop ventricular fibrillation during programmed ventricular stimulation with two or three extra stimuli at two sites.

• #12 Brugada Syndrome Guidelines: Guidelines Summary

  https://emedicine.medscape.com/article/163751-guidelines

  Asymptomatic athletes who are genotype-positive/phenotype-negative for Brugada syndrome can be allowed to take part in all competitive sports if precautionary measures are taken, such as avoidance of drugs that exacerbate BrS, electrolyte/hydration replenishment and avoidance of dehydration, avoidance or treatment of hyperthermia from febrile illnesses or training-related heat exhaustion or heat stroke, possession of a personal automatic external defibrillator as part of the athletes personal sports safety gear, and establishment of an emergency action plan with the appropriate school or team officials (class IIa; level of evidence, C). […] Competitive sports participation may be considered for an athlete with either previously symptomatic or electrocardiographically evident BrS, assuming appropriate precautionary measures and disease-specific treatments are in place and the athlete has been asymptomatic on treatment for at least 3 months (although treatment involving an implantable cardioverter-defibrillator is subject to additional recommendations) (class IIb; level of evidence, C).

• #12 Brugada Syndrome Guidelines: Guidelines Summary

  https://emedicine.medscape.com/article/163751-guidelines

  Consider catheter ablation in patients with a history of electrical storms or repeated appropriate ICD shocks. […] The 2013 HRS/EHRA/APHRS guidelines offer consistent recommendations. In addition, the guidelines find ICD implantation is not indicated in asymptomatic BrS patients with a drug-induced type I ECG and on the basis of a family history of sudden cardiac death (SCD) alone. […] A heart rhythm specialist or genetic cardiologist experienced in cardiac channelopathies should conduct a thorough evaluation of an athlete in whom such a disorder has been diagnosed or is suspected (class I; level of evidence, C). […] Symptomatic athletes with any suspected or diagnosed cardiac channelopathy should be restricted from all competitive sports until a comprehensive evaluation has been completed, the athlete and his or her family are well informed, a treatment program has been implemented, and the athlete has been asymptomatic on therapy for 3 months (class I; level of evidence, C).

• #13 Risk Score Model for Brugada Syndrome

  https://www.acc.org/latest-in-cardiology/journal-scans/2021/02/17/17/14/a-primary-prevention-clinical-risk

  Brugada syndrome (BrS) is an inherited cardiac channelopathy associated with ventricular arrhythmias and sudden cardiac death (SCD). […] This large multicenter study is the first to assess the major 16 risk factors associated with BrS in one study. The presence of the four most significant risk factors (noted in the Results above) is easily attained and should be considered in the evaluation of BrS for primary prevention of SCD. […] Fractionated QRS complexes have also been associated with major arrhythmic events in BrS.

• #14 Brugada syndrome // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/brugada-syndrome

  If someone in your family has Brugada syndrome, genetic testing can be done to determine if you have, or are at risk of, the condition. […] Treat a fever aggressively. Fever is a known trigger of irregular heartbeats in people with Brugada syndrome. Use fever-reducing medications at the first sign of a fever. […] Avoid drugs that may trigger an irregular heartbeat. Many drugs can increase the risk of an irregular heartbeat, including certain heart medications and antidepressants. Too much alcohol also can increase the risk. […] Avoid playing competitive sports. This might apply to people at high risk of a serious irregular heart rhythm. Ask your health care provider if you should avoid such sports activities. […] Some people with Brugada syndrome are prescribed medications, such as quinidine, to prevent a potentially dangerous heart rhythm. These drugs may be prescribed alone or with a medical device called an implantable cardioverter-defibrillator (ICD) that controls the heartbeat. […] If you have Brugada syndrome, you need regular health checkups to make sure the heart rhythm disorder is properly managed and controlled. Regular checkups can help your provider detect complications early and determine if a treatment change is needed.

• #15 Brugada Syndrome – Symptoms, Diagnosis and Treatments – British Heart Foundation – BHF

  https://www.bhf.org.uk/informationsupport/conditions/brugada-syndrome

  If your healthcare team think you have a higher risk of developing a potentially dangerous heart rhythm, they might suggest you have an ICD fitted to manage your condition and reduce your risk: ICD (implantable cardioverter defibrillator) – this is a small device fitted under your skin, usually near your collarbone. It will send a shock to reset your heartbeat if it becomes dangerously fast. […] In some cases, medication, such as beta blockers, may help prevent or reduce the occurrence of abnormal heart rhythms. […] You should always inform medical staff that you have Brugada Syndrome when you speak to them.

• #15 Brugada Syndrome – Symptoms, Diagnosis and Treatments – British Heart Foundation – BHF

  https://www.bhf.org.uk/informationsupport/conditions/brugada-syndrome

  Brugada syndrome is a rare condition that affects the electrical messages which control your heart rate. This causes an abnormal, very fast heart beat. It can be life-threatening for some, but treatment can control the risks and help you manage the condition. […] Theres currently no cure for Brugada syndrome. Most people can manage their risk of developing a very fast heart rhythm with some simple lifestyle choices. […] You might be advised to avoid things that could trigger a very fast heartbeat, like: A high temperature if you become unwell with a fever, you can help to lower it by taking paracetamol unless you’ve been told not to take it by your doctor. Dehydration if you have diarrhoea or have been sick for more than a day, you might become dehydrated and you should contact your doctor for advice. You might lose a lot of fluid and may need special rehydration drinks. Drinking too much alcohol too much alcohol can increase the risk of experiencing an irregular heart rhythm. Try to stick to the recommended weekly amount of alcohol. Taking certain medicines some medicines can trigger Brugada syndrome. Always let any medical professional you see know about your condition, so they can check prescribed medications are right for you. High intensity exercise or sports physical activity is good for your mental and physical health, but your doctor might advise you to find alternatives to some high intensity exercises. Some options are yoga or pilates. If you like getting out, riding a bike may be more suitable than running.

• #16 What You Should Know About Brugada Syndrome

  https://www.verywellhealth.com/brugada-syndrome-4098582

  The most well-proven method of preventing sudden death in Brugada syndrome is inserting an implantable defibrillator (ICD). […] In general, antiarrhythmic drugs should be avoided. Because of the way these drugs work on the channels in the cardiac cell membranes, they not only fail to reduce the risk of ventricular fibrillation in Brugada syndrome, but they may actually increase that risk. […] Whether someone with Brugada syndrome should receive an implantable defibrillator depends on whether their risk of sudden death is finally judged to be high or low. […] If the risk is high (based on symptoms or electrophysiologic testing), a defibrillator should be recommended. But implantable defibrillators are expensive and carry their own complications. So if the risk of sudden death is judged to be low, these devices are not currently recommended.

• #16 What You Should Know About Brugada Syndrome

  https://www.verywellhealth.com/brugada-syndrome-4098582

  People who are diagnosed with Brugada syndrome can almost always avoid a fatal outcome with appropriate treatment and can expect to live very normal lives. […] According to the 2015 recommendations, if young athletes with Brugada syndrome have had no symptoms associated with exercise, it is reasonable for them to participate in competitive sports if: They, their physicians, and parents or guardians understand the potential risks involved and have agreed to take necessary precautions. […] They avoid becoming overheated from fever or heat exhaustion. […] They avoid medications that can make Brugada syndrome worse. […] They stay adequately hydrated. […] An automatic external defibrillator (AED) is a normal part of their personal sports equipment. […] Team officials are able and willing to use the AED and perform CPR if necessary.

• #17 BrugadaDrugs.org | Safe drug use and the Brugada syndrome

  https://www.brugadadrugs.org/

  Many drugs have been reported to induce the type-1 ECG and/or (sometimes fatal) arrhythmias in Brugada syndrome patients. Therefore, it is necessary to advise patients with Brugada syndrome not to use these drugs, or to do so only in controlled conditions so that its potential pro-arrhythmic effect or the lack thereof can be documented and treated if necessary. […] It should be seriously considered to advise patients with Brugada syndrome to avoid drugs from the Red list (drugs to be avoided) because these drugs might result in arrhythmias, or to use these drugs only after extensive consideration and/or in controlled conditions. Drugs from the Orange list (drugs preferably avoided) have been associated with the appearance of the Brugada syndrome ECG and are therefore considered to be potentially proarrhythmic in patients with Brugada syndrome. […] Avoidance of (potential) proarrhythmic drugs and fever (a well known trigger of cardiac events in Brugada syndrome) is generally accepted to be an important part of (prophylactic) treatment.

• #18 Brugada syndrome — Knowledge Hub

  https://www.genomicseducation.hee.nhs.uk/genotes/knowledge-hub/brugada-syndrome/

  The mainstay of treatment in Brugada syndrome is careful lifestyle advice. […] Certain drugs may increase the likelihood of arrhythmia in the setting of Brugada syndrome. Patients should be directed to BrugadaDrugs.org for the list of drugs to avoid. […] Affected individuals should be given advice regarding prompt treatment of fever with antipyretics (such as paracetamol and ibuprofen) due to increased risk of arrhythmia. […] Affected individuals should also be advised to avoid excessive alcohol consumption, cocaine and cannabis use and eating large meals before bed due to increased risk of arrhythmia. […] Implantable cardioverter-defibrillator (ICD) implantation is recommended in individuals who have survived cardiac arrest or have documented episodes of spontaneous ventricular arrhythmia. […] ICD implantation should be considered in individuals with a spontaneous type 1 Brugada ECG pattern and syncope. […] Individuals with Brugada syndrome should be considered for genomic counselling (see the National Genomic Test Directory for eligibility criteria).

• #19 Brugada Syndrome – Causes, Symptoms, Diagnosis & Treatment

  https://www.medindia.net/health/conditions/brugada-syndrome.htm

  By using a medical device called an implantable cardioverter defibrillator […] Avoiding sodium channel blockers medications such as Ajmaline, Ethacizin, and Flecainide […] Genetic counseling and prenatal testing of family members of affected persons.

• #20 “Brugada Syndrome” A Silent and Deadly Threat to Thai Men – Chulalongkorn University

  https://www.chula.ac.th/en/highlight/137610/

  Once diagnosed, the medical team will advise the patient about the factors that will trigger the arrhythmia. This includes: Avoid Sodium channel-inhibiting drugs. Avoid high fever. If you are sick with a fever take antipyretics (ie. Paracetamol). Try to avoid high fever and reduce the temperature by wiping your body with damp wet cloth frequently. Avoid alcohol, intoxicating beverages, or illicit drugs of any kind such as marijuana, cocaine, etc. Avoid heavy meals that are high in carbohydrates and calories. […] Eating a high-carb diet doesn’t cause Brugada syndrome, but if you are diagnosed with Brugada syndrome, eating a high sugar, high-carb diet, heavy meals, and drinking alcohol, especially before sleep, can lead to cardiac arrhythmia and possibly death.

• #21 Brugada syndrome

  https://www.nhs.uk/conditions/brugada-syndrome/

  Brugada syndrome is a rare heart condition that’s usually inherited. It can affect your heart rhythm and can be life-threatening, but there are things you can do to reduce the risk of serious problems. […] If you have Brugada syndrome it’s important to avoid triggers that can cause problems with your heart rhythm. Your care team will give you advice about this. […] check with a doctor or pharmacist before taking any medicines some medicines can cause problems in people with Brugada syndrome […] take paracetamol or ibuprofen to help prevent a high temperature if you’re unwell […] do not drink too much alcohol keep to the recommended guidelines of no more than 14 units a week, spread over 3 days or more […] do not get dehydrated you may need rehydration solutions if you’re being sick or have diarrhoea […] do not take part in very strenuous exercise or sports.

• #22 Brugada syndrome – causes, symptoms and treatment | healthdirect

  https://www.healthdirect.gov.au/brugada-syndrome

  Brugada syndrome is a genetic condition. If a family member has Brugada syndrome, your doctor may recommend genetic testing for the affected gene. […] If you have the gene for Brugada syndrome, you have a 1 in 2 chance of passing the gene on to each of your children. If you are planning a pregnancy, it’s a good idea to see a genetic counsellor. […] Your doctor will advise you of ways to reduce the chance of developing a dangerous abnormal heart rhythm. […] You should treat any fever promptly, especially in children high body temperature increases the chance of complications. […] You should mention your condition to your doctors before any surgery and before taking new medicines or supplements. […] You should always check any new medicines with your doctor and pharmacist, including over-the-counter medicines. […] You should avoid alcohol and illicit drugs. […] You should have regular check-ups with your cardiologist.

• #23 Brugada Syndrome – SADS Foundation

  https://sads.org/sads-conditions/brugada-syndrome/

  Brugada Syndrome is an inherited condition, so once a family member is diagnosed, it is very important that the rest of your family be tested for the syndrome. […] Avoid drugs on the brugadadrugs.org list. […] Keep well hydrated, especially if vomiting and diarrhea. […] Reduce fever and keep it down; avoid heat exhaustion. […] Take an omega-3 fish oil supplement. […] Avoid excessive alcohol. […] Strictly avoid marijuana and cocaine.

• #24

  https://www.singhealth.com.sg/patient-care/conditions-treatments/brugada-syndrome

  There is no prevention for Brugada syndrome. Screening of immediate family members will help to identify individuals at risks and lifestyle modification advice can be given. […] Lifestyle modifications include avoidance of drugs which may potentially result in arrhythmias, proper treatment and control of fever, avoidance of excessive alcohol or large meals, maintaining good hydration and electrolyte balance.

• #25 Brugada syndrome and sports activity: from history to risk stratification

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-19/brugada-syndrome-and-sports-activity-from-history-to-risk-stratification

  The limitation of physical activity in these patients has been the main cornerstone of preventive therapy for decades. […] However, the low incidence of sudden cardiac death in the newest studies has gradually opened the possibility of practising agonistic sports activity for these subjects. […] We advise sport activities only in truly low-risk patients after going through a complete screening process. […] Eligibility can be granted: in asymptomatic subjects with type 2 or 3 pattern in the absence of a family history of juvenile sudden death; in subjects with drug-induced type 1 without risk factors. […] Eligibility may be reasonable in asymptomatic subjects with a spontaneous type 1 pattern, with no family history of sudden death or other minor risk factors and who have a negative EPS.

• #26 Brugada syndrome: Eligibility for subcutaneous implantable cardioverter-defibrillator after exercise stress test | Revista Portuguesa de Cardiologia (English edition)

  https://revportcardiol.org/en-brugada-syndrome-eligibility-for-subcutaneous-articulo-S2174204921000064

  Brugada syndrome (BrS) is a channelopathy associated with ventricular arrhythmias and sudden cardiac death. In patients at high risk of sudden death, an implantable cardioverter-defibrillator is indicated. Subcutaneous implantable cardioverter-defibrillators (S-ICDs) are an alternative to transvenous systems, with reduced risk of infection and complications associated with system extraction or explantation. […] Current guidelines recommend ICD implantation in patients with BrS with spontaneous type 1 ECG pattern and probable arrhythmia-related syncope. […] In view of the above, S-ICD systems have become a valid alternative for many patients, especially younger individuals who do not need a pacing function, as they offer a long expected device lifetime and consequently an inherently lower risk of complications, as they have no transvenous electrodes. […] These results demonstrate the importance of screening after EST in all patients with BrS and with indication for an S-ICD, and may influence decisions concerning which ICD to implant or whether to institute pharmacological measures that avoid cases of inappropriate therapies.

• #27 Brugada syndrome: Eligibility for subcutaneous implantable cardioverter-defibrillator after exercise stress test | Revista Portuguesa de Cardiologia (English edition)

  https://www.revportcardiol.org/en-brugada-syndrome-eligibility-for-subcutaneous-articulo-S2174204921000064

  Brugada syndrome (BrS) is a channelopathy associated with ventricular arrhythmias and sudden cardiac death. In patients at high risk of sudden death, an implantable cardioverter-defibrillator is indicated. Subcutaneous implantable cardioverter-defibrillators (S-ICDs) are an alternative to transvenous systems, with reduced risk of infection and complications associated with system extraction or explantation. […] Current guidelines recommend ICD implantation in patients with BrS with spontaneous type 1 ECG pattern and probable arrhythmia-related syncope. […] In this study, 16.7% of patients previously eligible for an S-ICD were no longer eligible after EST. This result demonstrates the importance of screening after EST in all patients with BrS and with indication for an S-ICD, and may influence decisions concerning which ICD to implant or whether to institute pharmacological measures that avoid inappropriate therapies.

• #28 S-ICD: an alternative for sudden cardiac death prevention in Brugada syndrome – Medical Conferences

  https://conferences.medicom-publishers.com/specialisation/cardiology/ehra-2025/s-icd-an-alternative-for-sudden-cardiac-death-prevention-in-brugada-syndrome/

  Low rates of appropriate and inappropriate shock delivery were observed in Brugada Syndrome (BrS) patients treated with subcutaneous implantable cardioverter defibrillator (S-ICD) as prevention of sudden cardiac death (SCD). […] ICD is the most effective life-saving treatment for patients with Brugada syndrome at risk for sudden cardiac death, Prof. Federico Migliore (University of Padova, Italy) informed.

• #29

  https://link.springer.com/article/10.1007/s00392-009-0075-4

  In Brugada syndrome implantable cardioverter defibrillator (ICD) therapy is associated with a high rate of inappropriate therapies, mainly due to supraventricular tachyarrhythmias (SVT) (2.714.1%/year). […] Programming of a single, high-rate VF zone in patients with Brugada syndrome and an implanted defibrillator is safe. Such programming may be associated with reduced inappropriate defibrillator discharges. A single detection zone with a high VF cut-off rate can be recommended in patients with Brugada syndrome.

• #30 Brugada Syndrome: Diagnosis, Clinical Manifestations, Risk Stratification and Treatment – Nova Science Publishers

  https://novapublishers.com/shop/brugada-syndrome-diagnosis-clinical-manifestations-risk-stratification-and-treatment/

  Lifestyle changes, such as never using drugs that may potentially induce ventricular arrhythmias and an immediate treatment of fever, should be recommended in all patients with diagnosis of BrS. […] Currently, the cornerstone of therapy for the prevention of sudden cardiac death (SCD) is an implantable cardioverter defibrillator (ICD). An accurate individual risk stratification to select patients for ICD implantation should be accurately performed, particularly in asymptomatic patients. […] Lastly, catheter ablation of the substrate located in the anterior epicardial region of the right ventricular outflow tract may be considered in patients with a history of arrhythmic storms or repeated appropriate ICD shocks.

• #31 Insights for Stratification of Risk in Brugada Syndrome | ECR Journal

  https://www.ecrjournal.com/articles/insights-stratification-risk-brugada-syndrome?language_content_entity=en

  The role of drugs in preventing arrhythmic events in BrS patients is an area of interest. […] Notably, quinidine has demonstrated a reduction in VF inducibility during a PVS protocol and significantly ameliorates VF recurrence during follow-up. […] The ablation of abnormal potentials at the outflow tract is able to revert the expression of the type 1 BrS pattern and normalise the ECG, which paves the way for interventional procedures aimed at substrate modification to improve patient prognosis. […] Risk stratification in BrS patients is challenging. […] Many different variables and interventions are being studied to increase the diagnostic yield and to maximise patient protection.

• #31 Insights for Stratification of Risk in Brugada Syndrome | ECR Journal

  https://www.ecrjournal.com/articles/insights-stratification-risk-brugada-syndrome?language_content_entity=en

  General recommendations are not conclusive, but intense monitoring, i.e. implantable loop recorders and close follow-up, is usually indicated. […] Two combined strategies might provide efficient clinical management. One strategy is effective lifestyle measures, including advising patients to avoid situations with increased risk for arrhythmic events for example, avoid drugs with potential adverse effects and promptly seek treatment for any episodes of fever and reminding them of the role of syncope as an alarm symptom to which they should pay special attention. […] The more up to date the risk stratification of asymptomatic BrS patients is, the more relevant it is for decision making in clinical practice. […] The relationship between the type 1 BrS pattern and fever, or some drugs, is clear, highlighting the importance of patient education on preventative measures.

• #32 Brugada syndrome: a review and the role of epicardial ablation in management | The Egyptian Heart Journal | Full Text

  https://tehj.springeropen.com/articles/10.1186/s43044-024-00485-3

  The use of catheter ablation has a very promising role in managing BrS patients; however, further studies are needed to assert its long-term benefit in preventing recurrent VF. […] Meanwhile, catheter ablation can be used in patients with recurrent VT/VF in experienced centers and patients should be counseled about the risks associated with epicardial access and the potential arrhythmogenic effects of drug administration.

• #33 Brugada syndrome – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/brugada-syndrome/symptoms-causes/syc-20370489

  If someone in your family has Brugada syndrome, genetic testing can be done to determine if you have, or are at risk of, the condition. […] Treatment of Brugada syndrome includes preventive measures such as reducing fever and avoiding medications that might trigger the arrhythmia. Some people with Brugada syndrome need a medical device called an implantable cardioverter-defibrillator (ICD).

• #34 Brugada syndrome – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/brugada-syndrome/

  If someone in your family has Brugada syndrome, genetic testing can be done to determine if you have, or are at risk of, the condition. […] Treat a fever aggressively. Fever is a known trigger of irregular heartbeats in people with Brugada syndrome. Use fever-reducing medications at the first sign of a fever. […] Avoid drugs that may trigger an irregular heartbeat. Many drugs can increase the risk of an irregular heartbeat, including certain heart medications and antidepressants. Too much alcohol also can increase the risk. […] Avoid playing competitive sports. This might apply to people at high risk of a serious irregular heart rhythm. Ask your health care provider if you should avoid such sports activities.

• #35 Management of patients with a Brugada ECG pattern

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-7/Management-of-patients-with-a-Brugada-ECG-pattern

  a) ICD To date, the only proven effective therapeutic strategy for the prevention of SCD in BS patients is the ICD. (28-30) […] It is recommended that BS patients should avoid all drugs that may induce a type 1 class ECG (Table 3). […] As fever may elicit the diagnostic ECG pattern and has also been recognized as a trigger of ventricular arrhythmias in BS, (42, 43) patients should be encouraged to treat it aggressively. […] Family screening of BS is strongly recommended in first-degree relatives (BS is an inherited disease transmitted in an autosomal-dominant way). […] All patients must have regular follow-ups in order to identify the development of symptoms. […] Genetic testing, when available, is recommended (5) to support clinical diagnosis, early detection of other affected family members and for research purposes. But diagnosis should not be based on it because it still has a low diagnostic yield.

• #36 Brugada Syndrome

  https://healthlibrary.uwmedicine.org/Search/134,217

  Many cases of Brugada syndrome are related to a genetic defect. It’s not possible for you to prevent inheriting this condition. But identifying the condition is key to preventing its possible complications. You may first want to talk with a genetic counselor if you have Brugada syndrome and plan to have children. […] An implanted cardioverter defibrillator (ICD) can help prevent sudden death linked to Brugada syndrome. When this device detects the start of an arrhythmia, it will either try to stop it with pacing or deliver a shock to reset it back into its regular rhythm. […] It’s also important to stay away from certain medicines that can make Brugada syndrome worse. […] Genetic testing can look for a mutation, such as with the SCN5A gene, that may help determine your risk.

• #37 Brugada Syndrome: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16813-brugada-syndrome

  If you inherited Brugada syndrome from a parent, you cant change that. If you know Brugada syndrome is in your family, you and your relatives can get a genetic test to check for it. Also, if youre considering pregnancy, you can see a genetic counselor to find out if youre at risk of passing it on to your children. […] Its not easy to hear that you have a condition that may cause a cardiac arrest. But knowing youre at risk allows you to take action to reduce that risk. Your healthcare provider can find the best treatment for you. It may give you peace of mind to have an automatic external defibrillator (AED) in your home and/or your childs school. Also, ask people who live or work with you to learn CPR.

• #38 Brugada Syndrome

  https://myhealth.umassmemorial.org/Search/134,217

  It’s also important to stay away from certain medicines that can make Brugada syndrome worse. […] Many cases of Brugada syndrome are related to a genetic defect. It’s not possible for you to prevent inheriting this condition. But identifying the condition is key to preventing its possible complications. You may first want to talk with a genetic counselor if you have Brugada syndrome and plan to have children. […] An implanted cardioverter defibrillator (ICD) may be considered to prevent sudden death linked to the syndrome if Brugada syndrome is diagnosed.

• #39 Sonia’s Story – Brugada Syndrome – Hearts4heart

  https://hearts4heart.org.au/patient/sonias-story/

  A short time after that I was diagnosed with a rare cardiac genetic syndrome called Brugada Syndrome. A syndrome which effects the sodium channels of the heart and which causes a fault in the hearts electrical system leading to a possible scenario of sudden cardiac arrest and the very real and high possibility of sudden cardiac death. […] Given the nature of some cardiac conditions, such as Brugada Syndrome where the syndrome may not show up routinely by way of an ECG, a person may not know that they actually have a life-threatening cardiac condition that they are living with. Therefore, I believe, we need to raise the importance of knowing basic CPR, as prompt by-stander assistance until a paramedic arrives is crucial. We need to look at the possibility of having access to portable defibrillators in public areas. We need to seriously consider a way of screening children from a young age for any signs of a possible cardiac condition.

• #40 Ablation in Brugada Syndrome for the Prevention of VF

  https://ctv.veeva.com/study/ablation-in-brugada-syndrome-for-the-prevention-of-vf

  This trial aims to develop evidence based curative treatment with optimal net benefit for patients with Brugada syndrome. […] A projected 92 patients in each group will be studied. […] Control arm – continued implanted cardioverter defibrillator therapy Intervention Arm Active Comparator group Description: ablation of areas of fragmented signal in the right ventricular outflow tract plus continued implanted cardioverter defibrillator therapy.

• #41

  https://journals.lww.com/10.1097/HCO.0000000000000941

  The main key to minimize overdiagnosis and overtreatment in the young population with a personal and/or family diagnosis of BrS is to perform a systematic but also individualized assessment. […] Appropriate diagnostic guidelines need to be created and age-specific risk stratification algorithms built for the young patient both with suspected and confirmed BrS.

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