Brugada Syndrome: One of the Main Causes of Sudden Death

Brugada syndrome is a recently discovered cause of sudden death. It's very difficult to diagnose because it doesn't present symptoms until it shows up through an episode of syncope or cardiac arrest. We'll tell you more about this disorder in this article.
Brugada Syndrome: One of the Main Causes of Sudden Death

Last update: 17 June, 2021

Brugada syndrome is one of the main causes of sudden death in the world, but its discovery took place only recently. Two brothers with that last name Brugada discovered it in 1992.

The disorder is genetic and consists of an alteration of the electrical transmission system of the heart. However, the symptoms don’t become evident until adulthood, and there are no previous signs to suspect it.

The genetic defect in question alters the ion channels of the myocardium, which is the muscular tissue of the heart. These ion channels allow for the exchange of positive and negative charges between the inside and outside of the myocardial cells. When they fail, the person is more prone to ventricular fibrillation.

Ventricular fibrillation is a serious type of arrhythmias. The heart beats uncontrollably at a very high rate, up to more than 200 or 300 beats per minute. This is a fatal arrhythmia if not addressed in time.

The signs and symptoms of Brugada syndrome

As we’ve already mentioned above, Brugada syndrome has no specific symptoms. It’s difficult to diagnose and detect because it doesn’t present previous alterations that warn of the existence of the alteration of the ion channels.

When the syndrome debuts in an adult individual, it appears directly with a certain degree of severity. Syncope, fainting, arrhythmia with palpitations, or cardiac arrest may occur.

Once the first episode has taken place, it’ll be the physician’s responsibility to suspect the existence of this syndrome. To do so, they must perform a series of electrocardiograms looking for what’s known as Brugada’s sign, which we’ll explain later.

This sign only appears on an electrocardiogram and the patient can’t feel it. Although it’s almost impossible to suspect in advance, there are some risk factors that we can take into account to refine the diagnosis. Among these factors we have:

  • Relatives with Brugada syndrome: Being a genetic disease, we must suspect it in family members of those who’ve already received a diagnosis.
  • Males: The disease is much more frequent among men than among women.
  • Asians: People of Asian descent are more likely to suffer from it.
A man clutching his chest.
Cardiac arrest may be the appearance of Brugada syndrome.

Continue reading: Electrocardiogram or EKG: Seven Steps to Interpret It

Diagnosis

Arriving at a diagnosis of Brugada syndrome is a challenge for any physician. In addition to suspicion, you have to be persistent enough to detect it reliably in a test.

The study of choice is an electrocardiogram. This is an electrical recording of cardiac activity that individuals can undergo in an outpatient clinic. This test is useful in detecting the Brugada sign, a particular form tracing in the study that warns of the presence of alterations in the ion channels.

Furthermore, the problem’s that not all patients show it on the electrocardiogram, and not all electrocardiograms always record it. The Brugada sign is an elevation of a segment of the tracing that’s very striking.

The physician measures this elevation in millimeters and, if it exceeds 2 millimeters and continues with a negative wave (downward), then they should suspect Brugada syndrome.

The other study that doctors may order is the electrophysiological study. This is no longer a complementary method that can take place in an office. Rather, it requires an operating room to insert a catheter into the body. Surgeons thread a catheter into the heart to record the activity of the organ from the inside.

A doctor reading an EKG.
Brigada syndrome is a change in the electrocardiogram that reveals the existence of the syndrome.

Find out more: Heart Palpitations: 4 Reasons You Might Feel Them

Is it possible to treat Brugada syndrome?

Unfortunately, it’s difficult to talk about treatment for Brugada syndrome. Strictly speaking, there’s no way to get rid of the condition for good. However, what does exist is a preventive modality for cardiac arrest.

This prevention is accomplished by the implantation of an implantable defibrillator in the patient’s body. This small device records the cardiac electrical activity and reacts with an electric shock if it detects ventricular fibrillation.

There are no medications for the syndrome and no surgeries that doctors can perform to remove defective areas of the heart. Therefore, regular check-ups are essential.

Living with Brugada syndrome

Nevertheless, it’s possible to live a long time with Brugada syndrome. Whether the patient receives the implantation of a defibrillator or not, regular medical check-ups are fundamental.

Once doctors have detected the disorder, follow-up by specialized cardiologists is essential in order to review the variables to warn of changes.

Similarly, the patient should learn to control the risk factors that could increase their risk of cardiac arrest.

It might interest you...
Heart Murmurs in Children
Step To HealthRead it in Step To Health
Heart Murmurs in Children

Most heart murmurs in children are harmless and we shouldn't worry. However, sometimes tests are needed to rule out other heart conditions.



  • Benito, Begoña, et al. “Síndrome de Brugada.” Revista espanola de cardiologia 62.11 (2009): 1297-1315.
  • Rojas, Elirub. “Síndrome de Brugada tipo 1 a propósito de un caso.” Vitae: Academia Biomédica Digital 69 (2017): 10.
  • Ortiz, José Manuel Monge, and Carlos I. Quesada Aguilar. “EKG Síndrome de Brugada.” Revista Clínica Escuela de Medicina UCR-HSJD 9.3 (2019): 53-55.
  • Berne, Paola, and Luis Enrique Aguinaga. “Síndrome de Brugada.” Rev Fed Arg Cardiol 41.4 (2012): 225-34.
  • Giménez, Nélida Inés, et al. “Síndrome de Brugada: Revisión.” Rev Posgrad 154 (2006): 16-20.