Brugada Syndrome

Brugada syndrome is an abnormality of the heart cells that disrupts the electrical activity in the heart and can cause life-threatening heart rhythms.

Symptoms

Because Brugada syndrome disturbs the heart's rhythm, blood is not pumped effectively through the body. Symptoms can include:

  • Fainting as a result of the brain not receiving enough blood
  • A chaotic, uncoordinated electrical pattern (called ventricular fibrillation). In this situation, the heart quivers and stops pumping blood. Sudden death usually occurs unless the heart is electrically shocked back into a normal pattern by a defibrillator.
Causes and Risk Factors

Electrical signals in the heart coordinate when and how often the heart beats. Electrically charged elements flow in and out of the heart cells through tiny pores called channels. They control the flow of charged particles through the heart's cells, and thereby the electrical activity of the heart. A defect in the channels causes periods of abnormal electrical activity.

In many cases, the cause of Brugada syndrome is not known. Genetics may play a role in some families.

Brugada syndrome often occurs in young adults.

Diagnosis

Brugada syndrome can be identified on an electrocardiogram (ECG). An ECG can be abnormal without the patient having dangerous heart rhythm irregularities - a condition called a Brugada sign. If heartbeat irregularities are also present, it is called Brugada syndrome.

A doctor may also recommend:

  • Continuous monitoring of the heart's electrical activity with a Holter monitor, - a device in which electrodes are attached to the chest and connected to a portable recorder. The Holter monitor allows the wearer to perform normal activities while the heart is being monitored during a 24-hour period.
  • Electrophysiologic studies. For these studies, the doctor threads electrodes attached to a long, thin tube (catheter) through a vein in the arm or leg and into the heart. The electrodes record how electrical impulses spread through the heart.
Treatment

Treatment depends on the risk of developing an abnormal heart rhythm (arrhythmia). Risk factors for arrhythmia include:

  • A history of relatives who died young as a result of sudden heart attacks
  • Having had heart rhythm problems
  • Having a history of fainting spells
People who are at high risk of sudden death usually undergo surgery to implant a defibrillator. The defibrillator is a small device that is inserted inside the chest. It continuously tracks the heart's rhythm and gives precise electrical shocks whenever they are needed to control abnormal, racing heartbeats.

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