Key result
S-ICD implantation provides uncomplicated recovery for a Brugada syndrome patient initially misdiagnosed with epilepsy.
Why the study?
Brugada syndrome is associated with an increased risk of ventricular fibrillation and sudden cardiac death, making early diagnosis critical despite diagnostic oversights.
Case Report (n=1)
Early recognition of Brugada Type 1 ECG patterns is critical to prevent misdiagnosis and ensure appropriate sudden cardiac death prophylaxis with an ICD.
Answers are grounded in this paper and cite their sources.
Early Brugada Type 1 recognition prevents misdiagnosis and ensures ICD prophylaxis; extends evidence for S-ICD in SCD prevention.
Background Brugada syndrome (BrS) is an unusual cardiac channelopathy associated with an increased risk of ventricular fibrillation (VF) and sudden cardiac death (SCD), highlighting the critical importance of early diagnosis. Case summary A 22-year-old male patient presented with recurrent episodes of syncope, palpitations, and dyspnoea. Initial electrocardiograms (ECGs) showing a Brugada Type 1 pattern were misinterpreted as incomplete right bundle branch blocks. The patient was erroneously diagnosed with epilepsy due to misinterpretation of his syncope episodes as seizures. After further investigations, including a propafenone provocation test and cardiac magnetic resonance imaging (MRI), BrS was confirmed. An electrophysiologic study showed no inducibility of ventricular tachycardia (VT) or VF, and a subcutaneous implantable cardioverter-defibrillator (S-ICD) was implanted for the prevention of SCD. The patient’s recovery was successful and uncomplicated. Discussion Brugada syndrome patients usually present with SCD, syncope, or severe arrhythmias. Syncope is the most common clinical presentation and identifies patients who could benefit from ICD. Only the Type 1 Brugada pattern is diagnostic, either spontaneous, unmasked by high precordial leads, or by sodium channel inhibition. Implantable cardioverter-defibrillator placement is indicated to prevent SCD. A subcutaneous defibrillator should be considered if the patient has no need for anti-bradyarrhythmia pacing. Conclusion Early recognition of BrS in patients with syncope is critical, especially for first-line providers interpreting ECGs, as it may prevent SCD.
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Ibarrola-Peña et al. (2026) conducted a case report in Brugada syndrome (n=1). Subcutaneous implantable cardioverter-defibrillator (S-ICD) was evaluated. Subcutaneous implantable cardioverter-defibrillator implantation provided successful and uncomplicated recovery for a 22-year-old male with Brugada syndrome initially misdiagnosed with epilepsy.
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