Treatment of Brugada Syndrome with a Spontaneous Type 1 Brugada ECG Pattern in Asymptomatic Patients

A spontaneous type 1 Brugada ECG pattern in an asymptomatic patient — no syncope — represents a distinct clinical situation that requires its own management approach. This protocol defines what to do in that specific setting.

Clinical Scenario

The patient carries a confirmed diagnosis of Brugada syndrome and presents with a spontaneous type 1 Brugada ECG pattern. Critically, the patient is asymptomatic — no prior syncope. This combination places the patient in a risk tier where management diverges from symptomatic presentations and requires specific evaluation before any intervention.

Approach Overview

In selected patients within this group, implantable cardioverter-defibrillator (ICD) therapy may be considered. The criteria that determine patient selection, and the full clinical algorithm governing when and how this applies, are set out in the complete protocol.

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References

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.

DOI: 10.1093/eurheartj/ehac262

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