6th March 2024

Brugada syndrome

This predominant sodium channelopathy is autosomal dominant with the SCN5A gene affected in 20% of cases. The heart is structurally normal but patients are at risk of sudden cardiac death from VT or VF. Presentation may be with cardiac arrest or with incidental finding of typical ECG changes including coved ST elevation of at least 2 mm in at least 2 precordial leads from V1-3. ECG changes may be transient and tests such as a flecainide (Na channel blocker) challenge can be used to reveal the characteristic ST changes.