Brugada Syndrome — Asymptomatic with Spontaneous Type 1 Brugada ECG Pattern

This protocol addresses a specific subset of Brugada syndrome: patients who are asymptomatic and present with a spontaneous (not drug-induced) type 1 Brugada ECG pattern. Risk stratification in this group is a recognised clinical challenge, and the approach differs meaningfully from symptomatic presentations.

Clinical scenario — Brugada syndrome

The patient has confirmed Brugada syndrome, is currently asymptomatic, and shows a spontaneous type 1 Brugada ECG pattern without a history of prior arrhythmic events. Programmed electrical stimulation (PES) may be considered as part of risk stratification in this setting.

Treatment approach (partial overview)

For selected patients in this asymptomatic, spontaneous type 1 group, device-based intervention is among the options that may be considered following electrophysiological assessment — though whether and how it applies depends on the findings of that evaluation.

Full indications, patient selection criteria, and the complete clinical algorithm are available in the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/eurheartj/ehac262

PES may be considered in asymptomatic patients with a spontaneous type I BrS ECG.

ICD implantation may be considered in selected asymptomatic BrS patients with inducible VF during PES using up to 2 extra stimuli.

View source ↗