Brugada Syndrome 

Exam Cram

• Cardiac Na+ channelopathy, inherited autosomal dominant

• Presentation: family history of sudden death, cardiac syncope (without exertion)

• ECG: V1-3: ST elevation; biphasic V1 T wave

• Diagnosis: infusion of ajmaline and rpt ECG

• Management: implantable cardioverter-defibrillator (ICD)

Outline

Background

• Na+ channelopathy

• First described by the 'Brugada Brothers' in 1992

Assessment

History

• Syncope without exertion

• Family history of sudden death

Examination

• Normal

Investigations

• ECG: V1 & V2 ST elevation & T wave changes

Diagnosis & Classification

Diagnostic criteria: ECG Brugada sign + clinical effect:

• VF or VT

• Family history of sudden death < 45yrs

• Brugada sign on ECG of family members

• Induced VT with electrical stimulation

• Syncope

• Nocturnal agonal respiration

Management

1. Implantable cardio-defibrillator (ICD)

Med Reg Notes

Can be Autosomal Dominant

Leads to syncope episodes usually from ventricular tachycardia

ECG 

• Varies, can be normal

• Pseudo RBBB and TWI in V1

• ST elevation in V1-3

References and Resources

1. https://litfl.com/brugada-syndrome-ecg-library/

Created in 2024.