Brugada Syndrome

Author: Michelle Lin, MD
Updated: 5/6/2011

Brugada Syndrome

  • Genetically linked, cardiac sodium channelopathy
  • High risk for sudden death in young, healthy adults because VTach/VFib
  • Mean age of sudden death = 41 ± 15 years
  • Higher prevalence in males and Asian descent
  • Atrial fibrillation associated in 10-20% cases

ECG findings

  • 2 types
  • Type 1 – Most specific for Brugada Syndrome
  • Highest risk for symptoms of syncope and sudden death

Examples of type 1, and type 2 Brugada ECG patterns

Differential diagnosis

_ _
After electrical cardioversion Friedreich ataxia
Arrhythmogenic RV dysplasia Early repolarization, esp in athletes
Atypical right BBB Hypothermia
Acute MI, especiall RV infarct Pericardial effusion
Acute myopericarditis Pulmonary embolism
Compression of RV outflow tract Left ventricular hypertrophy
Disorder of central/auton nerv system Mediastinal tumor
Dissecting aortic aneurysm Pectus excavatum
Duchenne muscular dystrophy


Indications for implantable cardiac defibrillator

Brugada Type 1 PLUS one of following:

  • Aborted sudden cardiac death
  • Syncope, seizure, or noctural agonal respirations without alternative cause
  • Family history of sudden cardiac death (likely from Brugada) AND positive electrophysiology (EPS) study
  • A positive EPS study

Otherwise, close followup with cardiologist.


  • Antzelevitch C, Brugada P, Borggrefe M, Brugada J, Brugada R, Corrado D, Gussak I, LeMarec H, Nademanee K, Perez Riera AR, Shimizu W, Schulze-Bahr E, Tan H, Wilde A. Brugada syndrome: report of the second consensus conference: endorsed by the Heart Rhythm Society and the European Heart Rhythm Association.Circulation. 2005 Feb 8;111(5):659-70. Epub 2005 Jan 17. [PubMed]