Risk stratification and management of Brugada Syndrome

Ondertitel:Emphasis in low risk populations

Identifying Brugada Syndrome patients at risk of sudden cardiac death and ventricular arrhythmias is of utmost importance. However, is a challenging and complicated task. Patients at high risk of events are easily identified. They are those with previous aborted sudden cardiac arrest or syncope and consensus is that they should receive an implantable cardioverter defibrillator. Great controversy exists still around the most appropriate management of those at lower risk. Current clinical guidelines and consensus documents do not offer clear recommendations. We have developed a risk score model to predict events that might help in the decision process of these patients. It has a high predictive performance, in both the overall Brugada Syndrome population but, interestingly, in asymptomatic patients. It includes novel risk factors such as sinus node dysfunction or early familial antecedents of sudden cardiac death. Value of inducible ventricular arrhythmias is still not fully elucidated. Inducible arrhytmias identify patients at higher risk. Non-inducible patients, especially if asymptomatic have a good prognosis. Asymptomatic, drug induced and women are specific subgroups with a better prognosis, however arrhythmic events might happen in the long term. Implantable cardioverter defibrillator remains the only strategy to prevent sudden cardiac death in high risk Brugada Syndrome patients. After a mean of 7 years, around 16% of patients will receive an appropriate therapy and 18% will have inappropriate shocks.

Jaar van publicatie:2017

Trefwoorden:Brugada syndrome