13th March 2024

Diagnostics

For a diagnosis of Brugada syndrome to be made, a patient requires a Brugada pattern on ECG and either symptoms or a family history in keeping with Brugada syndrome. The diagnostic ECG changes are coved ST-segment elevation in one or more of the right precordial leads (V1-3) followed by a negative T wave.

In individuals where Brugada syndrome is suspected but the basal ECG is not diagnostic, ECG abnormalities can be elicited by a drug challenge with a sodium channel blocker such as flecainide.

It is important to exclude other causes for V1-3 ST elevation on ECG, such as ischaemia or pericarditis.

The diagnosis commonly occurs after a patient has a cardiac event and then is found to have ECG abnormalities. Those with Brugada syndrome will require genetic testing.