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Brugada Syndrome

102 bytes added, 08:39, 7 May 2009
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==Diagnosis and treatment==
*Patients who are symptomatic (unexplained syncopesyncopes, ventricular tachycardias or survivors of aborted sudden cardiac death) may have a mortality symptom recurrence risk of up 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 VFventricular 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 (very) controversial.
*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:
**A number of medications should not be taken (amongst which beta-blockers, and sodium channel blockers such as certain anti-depressants and anti-arrhythmics, see [])
**Rigorous treatment of fever with paracetamol / Tylenol, as fever may elicited the Brugada ECG and arrhythmias in some patients.
* Spontaneous Type I ECGs do however appear to be more prevalent in patients who experienced symptoms.
For a full list of the diagnostic criteria, see <cite>Wilde</cite>

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