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Brugada syndrome

5-minute read

Brugada syndrome is a condition that can disrupt the rhythm of your heart. It can cause fainting or, in serious cases, a cardiac arrest. If you have Brugada syndrome, which can be inherited, there are many ways to look after yourself.

It might be the cause of a fatal cardiac arrest in some people whose death could not be fully explained.

Brugada syndrome is also known as lai tai in Thailand, pokkuri in Japan and bangungut in the Philippines. It might be the cause of death for some people who have died in the past from a cardiac arrest, but whose death couldn’t be explained. 

What causes Brugada syndrome?

Your heartbeat is controlled by small electrical signals, which ensure blood is pumped through your heart effectively. In healthy people, most of the time the heart beats regularly.

Brugada syndrome disturbs this electrical rhythm, so your heart can beat either irregularly or regularly but very fast. This is known as an arrhythmia.

Brugada syndrome usually occurs when a faulty gene is passed on from a parent to their child. If you have Brugada syndrome, you have a 1 in 2 chance of passing the gene on to any of your children.

Symptoms of Brugada syndrome

Not all people with Brugada syndrome will experience noticeable symptoms.

People without symptoms may still show abnormalities on an electrocardiogram (ECG), a test that measures your heart’s electrical activity. Some people only discover they have Brugada syndrome when they first have an ECG in their 40s or 50s.

In those who experience symptoms, Brugada syndrome often emerges between ages 15 to 40. Usually, people notice a racing or irregular pulse, also known as palpitations, when they are resting. These palpitations can come and go.

The arrhythmia caused by Brugada syndrome makes the heart pump less efficiently, meaning you have less blood than usual going to your brain. This can make you feel dizzy and faint. 

Very rarely, the heart can suddenly stop beating. This is known as a cardiac arrest and it is a medical emergency. 

If you suspect someone is having a cardiac arrest, loses consciousness and stops breathing, call triple zero (000) and ask for an ambulance. Start cardiopulmonary resuscitation (CPR) as soon as possible. 

Diagnosis of Brugada syndrome

It’s quite common for people with Brugada syndrome to discover they have the condition when they are being treated after a fainting spell or after being resuscitated from a cardiac arrest. 

The diagnosis is confirmed by an ECG. Sometimes, it takes more than one ECG because the irregularities don't occur all the time. 

If it's suspected that you have Brugada syndrome, you may be given a specific drug to see how you react while having the ECG. In this case, the ECG will most likely be done in a hospital. Otherwise, it can be done in your doctor’s rooms.

You might also be asked to have an electrophysiology study, which allows doctors to test how your heart responds to electrical stimuli, and which might try to reproduce the abnormal rhythm. 

Some people discover they have Brugada syndrome after having a genetic test. Family members of a person with Brugada syndrome are often encouraged to be tested for the condition so that, if they have a faulty gene, they can see a cardiologist to manage their heart health. 

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.

Brugada syndrome treatment

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

If your condition is serious, you may need to have an implantable cardioverter defibrillator fitted. This device can send electrical pulses to the heart to overcome irregular or stopped heartbeats. 

Otherwise, your doctor may recommend drugs that help prevent arrhythmias. 

Preventing triggers

If you have Brugada syndrome, it is important to avoid anything that can make your heart beat more irregularly and trigger an episode. Potential triggers include:

  • medical drugs that aggravate the condition – there is a list of drugs to avoid at, and you can carry this letter to your doctor, which explains what they are
  • excessive alcohol 
  • high-carbohydrate meals 
  • hot baths 
  • cocaine 

It’s also important to:

  • treat any fever promptly, especially in children, since high 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 medications or supplements

It’s also a good idea to encourage your relatives to consider genetic testing. It may also be possible to do pre-natal testing if you wish.

When to seek help

If you have Brugada syndrome and you have fainted and recovered consciousness, seek emergency medical attention.

If another person has collapsed with a cardiac arrest:

  • Ensure that neither you nor they are in danger then 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.

More information

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Last reviewed: April 2018

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