Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jun 6;16(6):e61837.
doi: 10.7759/cureus.61837. eCollection 2024 Jun.

Advances and Challenges in the Management of Brugada Syndrome: A Comprehensive Review

Billy McBenedict  1 , Berley Alphonse  1 , Jeshua N Devan  2 , Gurinder Singh  2 , Kang Suen Goh  3 , Ryan Chun Chien Yau  3 , Sara Elamin  2 , Vaishnavi Jamched  2 , Aaron A Abraham  1 , Gabriella Valentim  4 , Bruno Lima Pessôa  1 , Wilhelmina N Hauwanga  2
Affiliations
Review

Advances and Challenges in the Management of Brugada Syndrome: A Comprehensive Review

Billy McBenedict et al. Cureus. .

Abstract

Brugada syndrome (BrS) is an inherited arrhythmogenic disorder marked by distinctive ST-segment elevations on electrocardiograms (ECG) and an increased risk of sudden cardiac death. Characterized by mutations primarily in the SCN5A gene, BrS disrupts cardiac ion channel function, leading to abnormal electrical activity and arrhythmias. Although BrS primarily affects young, healthy males, it poses significant diagnostic challenges due to its often concealed or intermittent ECG manifestations and clinical presentation that can mimic other cardiac disorders. Current management strategies focus on symptom control and prevention of sudden death, with implantable cardioverter-defibrillators (ICD) serving as the primary intervention for high-risk patients. However, the complications associated with ICDs and the lack of effective pharmacological options necessitate a cautious and personalized approach. Recent advancements in catheter ablation have shown promise, particularly for managing ventricular fibrillation (VF) storms and reducing ICD shocks. Additionally, pharmacological treatments such as quinidine have been effective in specific cases, though their use is limited by availability and side effects. This review highlights significant gaps in the BrS literature, particularly in terms of long-term management and novel therapeutic approaches. The importance of genetic screening and tailored treatment strategies to better identify and manage at-risk individuals is emphasized. The review aims to enhance the understanding of BrS and improve patient outcomes, advocating for a multidisciplinary approach to this complex syndrome.

Keywords: arrhythmogenic disorders; brugada syndrome; catheter ablation; implantable cardioverter-defibrillators; scn5a gene; sudden cardiac death.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Mind map exploring the etiology and management strategies
Generated with Miro Mind Mapping Tool. The mind map was constructed from the articles included in the review [5-26].
See this image and copyright information in PMC

References

    1. Exercise restrictions for patients with inherited cardiac conditions: current guidelines, challenges and limitations. Hammond-Haley M, Patel RS, Providência R, Lambiase PD. Int J Cardiol. 2016;209:234–241. - PubMed
    1. Impact of a novel algorithm designed to reduce T-wave oversensing with the subcutaneous defibrillator in a patient with type I Brugada electrocardiogram. Boveda S, Laarakker MC, Cardin C, Albenque JP. HeartRhythm Case Rep. 2018;4:31–33. - PMC - PubMed
    1. New insights into the genetic basis of inherited arrhythmia syndromes. Gray B, Behr ER. Circ Cardiovasc Genet. 2016;9:569–577. - PubMed
    1. Management of ventricular arrhythmias in suspected channelopathies. Obeyesekere MN, Antzelevitch C, Krahn AD. Circ Arrhythm Electrophysiol. 2015;8:221–231. - PubMed
    1. Brugada syndrome: progress in genetics, risk stratification and management. Romero J, Li DL, Avendano R, Diaz JC, Tung R, Di Biase L. Arrhythm Electrophysiol Rev. 2019;8:19–27. - PMC - PubMed

LinkOut - more resources