Recent advances in the treatment of Brugada syndrome

Expert Review of Cardiovascular Therapy
Mariana Argenziano, C Antzelevitch

Abstract

Brugada syndrome (BrS) is an inherited cardiac arrhythmia syndrome characterized by ST-segment elevation in right precordial ECG leads and associated with sudden cardiac death in young adults. The ECG manifestations of BrS are often concealed but can be unmasked by sodium channel blockers and fever. Areas covered: Implantation of a cardioverter defibrillator (ICD) is first-line therapy for BrS patients presenting with prior cardiac arrest or documented VT. A pharmacological approach to therapy is recommended in cases of electrical storm, as an adjunct to ICD and as preventative therapy. The goal of pharmacological therapy is to produce an inward shift to counter the genetically-induced outward shift of ion channel current flowing during the early phases of the ventricular epicardial action potential. This is accomplished by augmentation of ICa using □□adrenergic agents or phosphodiesterase III inhibitors or via inhibition of Ito. Radiofrequency ablation of the right ventricular outward flow tract epicardium is effective in suppressing arrhythmogenesis in BrS patients experiencing frequent appropriate ICD-shocks. Expert commentary: Understanding of the pathophysiology and approach to therapy of BrS has advanced considerably in r...Continue Reading

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Citations

Jan 15, 2020·European Cardiology·Afik D Snir, Hariharan Raju
Jul 21, 2020·Acta Cardiologica·Haarika KorliparaSrinivas Pentyala
Oct 17, 2020·General Hospital Psychiatry·Anuj RastogiJohn Lally
Aug 28, 2021·Current Problems in Cardiology·Alejandro Olaya-SanchezJosep Brugada

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