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Brugada Syndrome: Difference between revisions
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==Diagnosis and treatment== | ==Diagnosis and treatment== | ||
*Patients who are symptomatic (unexplained | *Patients who are symptomatic (unexplained syncopes, ventricular tachycardias or aborted sudden cardiac death) may have a symptom recurrence risk of 2 to 10% per year. In these patients an [[:w:nl:Internal_Cardiac_Defibrillator|ICD]] is adviced to be implanted. Further, life-style advices are given (see below). | ||
*Some groups advice an electrophysiological investigation (inducibility of | *Some groups advice an electrophysiological investigation (inducibility of ventricular fibrillation) for risk assessment in Brugada patients,<cite>brug2</cite><cite>brug3</cite> but others could not reproduce the predictive value of these tests,<cite>priori</cite><cite>eckhardt</cite> so the value of inducibility is controversial. | ||
*In large studies familial sudden death did not appear to be a risk factor for sudden death in siblings. | *In large studies familial sudden death did not appear to be a risk factor for sudden death in siblings. | ||
*In asymptomatic patients in whom the Brugada ECG characteristics are present (either spontaneously or provoked by fever or sodium channel blockers like ajmaline, procainimde or flecainide) life style advices are given, which include: | *In asymptomatic patients in whom the Brugada ECG characteristics are present (either spontaneously or provoked by fever or sodium channel blockers like ajmaline, procainimde or flecainide) life style advices are given, which include: | ||
**A number of medications should not be taken (amongst which | **A number of medications should not be taken (amongst which sodium channel blockers such as certain anti-depressants and anti-arrhythmics, see [http://www.brugadadrugs.org www.BrugadaDrugs.org]) | ||
**Rigorous treatment of fever with paracetamol / Tylenol, as fever may elicited the Brugada ECG and arrhythmias in some patients. | **Rigorous treatment of fever with paracetamol / Tylenol, as fever may elicited the Brugada ECG and arrhythmias in some patients. | ||
* Spontaneous Type I ECGs do | * Spontaneous Type I ECGs do appear to be more prevalent in patients who experienced symptoms. | ||
For a full list of the diagnostic criteria, see <cite>Wilde</cite> | For a full list of the diagnostic criteria, see <cite>Wilde</cite> | ||