Key result
Patients with Brugada syndrome require meticulous perioperative management, including avoidance of triggering medications and continuous monitoring, to prevent potentially fatal ventricular arrhythmias.
Safe anesthetic management of patients with Brugada syndrome requires detailed knowledge of the condition to prevent perioperative ventricular arrhythmias and sudden cardiac death.
Reinforces perioperative vigilance for Brugada syndrome; leaves open need for prospective protocol standardization.
Brugada syndrome is an autosomal dominant genetic disorder associated with an increased risk of sudden cardiac death, as well as ventricular tachyarrhythmias.The defective cardiac sodium channels result in usual electrocardiographic findings of a coved-type ST elevation in precordial leads V1 to V3. The majority of patients have uncomplicated courses with anesthesia, surgery, and invasive procedures. However there is risk of worsening ST elevation and ventricular arrhythmias due to perioperative medications, surgical insult, electrolyte abnormalities, fever, autonomic nervous system tone, as well as other perturbations. Given the increasing numbers of patients with inherited conduction disorders presenting for non-cardiac surgery that are at risk of sudden cardiac death, safe anesthetic management depends upon a detailed knowledge of these conditions.
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Mookadam et al. (2015) conducted a review in Brugada syndrome. Perioperative management was evaluated. Patients with Brugada syndrome require meticulous perioperative management, including avoidance of triggering medications and continuous monitoring, to prevent potentially fatal ventricular arrhythmias.
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