Brugada Syndrome: A Review

The Brugada syndrome is a form of cardiac arrhythmia, characterized by electrocardiographic ST-Segment elevation in right precordial leads that affect young male patient, predisposing to malignant ventricular arrhythmia and sudden cardiac deaths. The majority of the patients with Brugada syndrome remain asymptomatic, however, patient can present with symptom like syncope, palpitation and aborted sudden cardiac death. Several pathogenic genes have been identified as associated with the disease but SCN5A is most prevalent one. The Brugada syndrome is diagnosed by typically cove shaped ST-segment elevation of >2 mm in greater than one precordial lead V1 and V2, occurring spontaneously or after provocative drugs test with IV administration of class 1 antiarrhythmic drug such flecainide or Ajmaline. Risk stratification and the need for treatment depend on the patient symptom, electrocardiography, family history and electrophysiological study. The treatment by implantable cardioverter defibrillators, the only effective treatment to date is appropriate. Other treatment options included pharmacological therapy (Quinidine) and Radiofrequency ablation of ventricular ectopies. This brief review focuses on epidemiology of Brugada syndrome, Genetic basis, mechanism, clinical presentation, ECG changes, risk stratification, Diagnostic criteria and management.