What is Brugada syndrome?

Brugada syndrome is a rare, genetic condition that can disrupt your heart rhythm. It can cause dizziness or, in serious cases, cardiac arrest.

Your heartbeat is controlled by electrical impulses. This causes your heart to beat regularly and pump blood round your body. In Brugada syndrome, although your heart structure is usually normal, there is a disturbance of the electrical activity in your heart. This can cause an abnormal heart rhythm (arrhythmia) which can be fatal.

If you have Brugada syndrome, you’re more likely to develop a dangerous arrhythmia if you have a fever (high body temperature) or if you’re exposed to some specific medicines.

What causes Brugada syndrome?

Brugada syndrome is a genetic condition. It is usually caused by inheriting a faulty gene from one of your parents. Rarely, it can result from other issues such as structural problems in your heart or certain medicines.

If you the gene for Brugada syndrome, you have a 1 in 2 chance of passing the gene on to each of your children.

What are the symptoms of Brugada syndrome?

You may have Brugada syndrome without any symptoms.

If you have symptoms, they usually appear in young adulthood and occur at night or at rest in the daytime and may include:

• racing or irregular pulse (palpitations)
• feeling dizzy and faint
• cardiac arrest, if your heart suddenly stops beating (very rare)

Some unexplained sudden deaths may be caused by cardiac arrest due to Brugada syndrome. Brugada syndrome is the most common inherited cardiac cause of sudden death in people aged under 40 years of age.

How is Brugada syndrome diagnosed?

Brugada syndrome is usually diagnosed by an electrocardiogram (ECG) test showing the characteristic ‘Brugada pattern’. Your doctor may identify this during a routine ECG test without you experiencing any symptoms.

Your doctor may also perform an ECG after you have palpitations or have fainted, or after you are resuscitated from a cardiac arrest.

Sometimes, it takes more than one ECG to diagnose Brugada syndrome, because the typical Brugada pattern doesn't occur all the time.

If your doctor suspects Brugada syndrome, you may be given a specific medicine to see if this brings on changes in your ECG. This test is done in hospital so you can be monitored for symptoms and any problems can be identified and treated quickly.

You might need to have an electrophysiology study. This allows your doctor to see how your heart responds to electrical stimuli (triggers), and help your doctor bring on and record an abnormal heart rhythm (arrhythmia).

If a family member has Brugada syndrome, your doctor may recommend genetic testing for the faulty gene. However, genetic screening won’t find all cases. A negative screening result doesn't mean that you don't have Brugada syndrome. You can read more about genetic testing here.

Your doctor may refer you to a cardiologist for diagnosis and management.

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How is Brugada syndrome treated?

Your cardiologist will discuss with you the best treatment for your particular situation.

You may need to have an implantable cardioverter defibrillator (ICD) fitted. This device monitors your heart rhythm and can deliver an electric shock to your heart to control dangerous abnormal heart rhythms.

Your doctor may recommend medicines to help prevent or treat arrhythmias.

Can Brugada syndrome be prevented?

If you carry the faulty gene, Brugada syndrome can’t be cured. Your doctor can advise you of measures to reduce the chance of developing a dangerous abnormal heart rhythm.

You should avoid anything that can make your heart beat more irregularly and trigger an episode of arrhythmia. Triggers include fever, excessive alcohol, cocaine and some medicines.

You can see a list of medicines to avoid at brugadadrugs.org.

You should:

• treat any fever promptly, especially in children — high body temperature increases the risk of complications
• have regular check-ups with your cardiologist
• mention your condition to your doctors before any surgery and before taking new medicines or supplements

You should also encourage your relatives to consider genetic testing. If you are planning a pregnancy, it’s a good idea to see a genetic counsellor to discuss your options.

When should I see my doctor?

If you have Brugada syndrome and you faint and then recover consciousness, seek urgent medical attention at the emergency department of your local hospital.

If another person has collapsed with a cardiac arrest:

• Call triple zero (000) and ask for an ambulance.
• If calling triple zero (000) does not work on your mobile, try calling 112. (This number is only for mobile phones.)
• Start CPR as soon as possible after calling for help. See here how to perform CPR.

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Resources and support

• To find a genetic counsellor, visit the Australian Society for Genetic Counsellors.
• Visit the Heart Foundation to find more information about heart diseases.
• To assist with research into genetic heart diseases, you can enrol in the Australian Genetic Heart Disease Registry.
• BrugadaDrugs.org lists the medications to be avoided if you have Brugada Syndrome