Brugada Syndrome

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Definition

• Sudden unexpected nocturnal death
• Includes only idiopathic cases of Sudden Cardiac Death

Epidemiology

1. Incidence: Uncommon
2. Accounts for <5% of Sudden Cardiac Death cases
3. Family History of sudden death events often present
4. Most common in men
5. Greater Incidence in Southeast asia

• Northeastern Thailand (40/year per 100,000)
• Japan
• Philipines

Pathophysiology

Inherited disorder of myocardial sodium channels

Associated EKG findings

1. Prolonged QT Interval
2. Brugada Sign
   • Seen best in the right precordial leads (V1-V3)
   • End of QRS marked by significant upward deflection
   • ST segment elevation
3. Associated with Right Bundle Branch Block

Symptoms

1. Often asymptomatic until terminal event (40%)
2. Exertional Syncope history may be present

References

1. Antzelevitch (2003) J Am Coll Cardiol 41(10):1665
2. Brugada (1992) J Am Coll Cardiol 20(6):1391
3. Littmann (2003) Am Heart J 145(5):768
4. Meyer (2003) Am Fam Physician 68(3):483