The Inherited Arrhythmia Clinic in Madison, Wisconsin, was established to meet the needs of individuals and families with possible inherited arrhythmia syndromes, including Brugada Syndrome, during which the ventricles beat too quickly to allow blood to circulate efficiently in the body.
About Brugada Syndrome
The heart serves as a pump that is stimulated by electrical signals to beat many times each minute, and is made up of millions of cells that discharge and recharge their electricity with each heartbeat. Brugada syndrome is caused by an abnormality in the heart's electrical system that causes the heart to develop an abnormal rhythm (arrhythmia) that is faster than normal. This arrhythmia can become dangerous, causing the heart to beat quickly and irregularly, preventing adequate blood flow to the brain and the rest of the body.
Brugada syndrome is caused by an abnormality in the heart's ion channels (proteins that control the passage of important chemicals such as potassium, calcium and sodium) that is due to a genetic mutation. Brugada syndrome is rare. Although both males and females can have the condition, males are more likely to have symptoms.
Brugada Syndrome Symptoms
People with Brugada syndrome have structurally normal hearts and generally appear to be in good health. The symptoms of Brugada syndrome can range from dizzy spells and fainting episodes to sudden cardiac death. Some people more frequently experience these symptoms when they are ill and have a fever. Most often, a person will have no warning that they are going to faint. Brugada syndrome most frequently presents in men in their thirties butcan be seen in people of all ages.
Diagnosing Brugada Syndrome
In making the diagnosis of Brugada syndrome, our clinic staff takes into account:
- Specific findings on the ECG (a test that measures the electrical signals of the heart beat)
- Family history information
- Results of genetic testing
Sometimes, additional tests such as a drug challenge or an electrophysiology (EP) study may be recommended if a patient's presentation does not allow for a straightforward diagnosis.
Treating Brugada Syndrome
Currently, there is no cure for Brugada syndrome. Many patients with this diagnosis receive an implantable cardioverter defibrillator, which is essentially a pacemaker that can shock the heart in the event of a dangerous arrhythmia. We also make recommendations for a person's lifestyle, such as eliminating or avoiding activities that could trigger a dangerous heart rhythm.
Brugada Syndrome and Prescription Medication
In all patients with Brugada syndrome, we recommend avoiding all drugs that could increase the likelihood of an arrhythmia. A list of these drugs is available at BrugadaDrugs.org. It is important to check this website any time a new medication is prescribed.
Brugada Syndrome and Genetics
The majority of genes associated with Brugada syndrome are important for the proper formation of the ion channels in the heart. Genetic testing is available to determine if a mutation, or gene change, can be found in any one of these genes.
Through testing we are typically able to identify a gene mutation in about 30 percent of patients that have symptoms of Brugada syndrome. This means that there are still many patients who have genetic mutations that cannot be identified at present. In the event that a mutation is not detectable in a patient with Brugada syndrome, we will make recommendations for screening family members who may also be at risk.
If a person does have a genetic mutation identified, we can test other family members to determine if they share this same genetic mutation. Relatives with an identified mutation have a 50 percent chance of sharing the same gene abnormality. The presence of a genetic mutation does not automatically indicate that a family member will also have symptoms or will develop symptoms of Brugada syndrome in the future. It does, however, let us know who should be evaluated by a cardiologist and which family members do not need a cardiac evaluation for Brugada syndrome.