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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Brugada Syndrome and Its ECG Features
Introduction
Brugada syndrome is a genetic disorder that affects the electrical activity of the heart and increases the risk of sudden cardiac death due to ventricular arrhythmias. It is often diagnosed with characteristic findings on an electrocardiogram (ECG).
ECG Patterns of Brugada Syndrome
There are three distinct ECG patterns associated with Brugada syndrome, with Type 1 being the most diagnostic:
1. Type 1 (Coved-Type ST Elevation)
- ST elevation of ≥2 mm in leads V1-V2
- Followed by a negative T wave
- May appear spontaneously or after provocation by sodium channel blockers (e.g., ajmaline, flecainide)
2. Type 2 (Saddleback ST Elevation)
- ST elevation ≥2 mm but with a “saddleback” appearance
- Not as specific for Brugada syndrome
3. Type 3 (Mixed Features)
- ST elevation <2 mm with either coved or saddleback morphology
Diagnosis and Management
- ECG findings should always be correlated with symptoms (syncope, cardiac arrest) and family history.
- Confirmatory tests: Sodium channel blocker challenge test, genetic testing (mutations in SCN5A gene in some cases), and electrophysiological studies.
- Treatment: First-line treatment is the implantation of an implantable cardioverter-defibrillator (ICD) in high-risk patients.
- Lifestyle modifications: Avoid fever, certain drugs, and excessive alcohol.
Conclusion
Brugada syndrome is an important cause of sudden cardiac death in young individuals. Early recognition of its ECG pattern can be life-saving. If you suspect Brugada syndrome, evaluation by a cardiologist specializing in electrophysiology is crucial.
Source recommendations
1. European Society of Cardiology Guidelines on Sudden Cardiac Death
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
- https://academic.oup.com/eurheartj/article/43/40/3997/6675633
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
- https://pubmed.ncbi.nlm.nih.gov/29191938/
- https://www.sciencedirect.com/science/article/pii/S2405500X22010945
2. American Heart Association Guidelines on Arrhythmias
- https://www.heart.org/en/health-topics/arrhythmia
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
- https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
- https://pubmed.ncbi.nlm.nih.gov/29084733/
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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