[Brugada syndrome].

ABSTRACT

Brugada syndrome is characterized by the right bundle branch block type electrocardiogram (ECG) with ST-segment elevation and ventricular fibrillation (Vf) attack in patients without obvious heart disease. Its background is considered to be the genetic Na channelopathy. The coved type is a typical morphology and is classified into type 1 in the European Society of Cardiology (ESC). In general, the coved type and the saddel-back type (type 2, 3 in the ESC) are interchangeable, and the latter is more frequently detected clinically. For diagnosis of the Brugada syndrome, confirmation of the type 1 morphology is needed. Administration of Na channel blocker, pilsicainide, is a sensitive test for confirmation of the type 1. When the type 1 has one of 7 items recommended by the ESC, the patient is diagnosed with Brugada syndrome. ECG finding alone is classified into patient with Brugada type ECG. As there is no reliable medical treatment, implantation of a cardioverter defibrillator is indicated in patients with Brugada syndrome, and observation alone in those with Brugada type ECG.