Loading the player...Sudden Death Syndrome Dr. Andrew Krahn, MD, FRCPC, and Kirsten Bartels, MSc, CCGC, Genetic Counsellor, discusses Sudden Death Syndrome and how it is diagnosed and treated.
Loading the player...What is Brugada Syndrome? Dr. Andrew Krahn, MD, FRCPC, Cardiologist, and Julie Hathaway MSc, CGC, CCGC, Genetic Counsellor, discuss a genetic cardiac condition called Brugada Syndrome.
Brugada Syndrome is a delay in the signal in the front of the heart. When we do an EKG, we can see or record this delay, and it catches our attention because it’s unusual. It’s something that’s seen more often in men, and it’s seen more often in Asians. You cannot really feel Brugada Syndrome, unless that EKG is associated with something that leads to a fainting spell or a seizure. The abnormal heart rhythm is what you feel, not the actual Brugada EKG.
Most patients with Brugada have no symptoms, feel well, and won’t ever have a problem. Occasionally patients with Brugada – this delayed signal – will lead to an abnormal heart rhythm. That abnormal heart rhythm can cause the person to faint, it can cause them to have a seizure, they can collapse and they can even die suddenly, most often at rest or in their sleep.
Brugada occasionally runs in families, though most of the time we don’t find other family members are affected when a person has a Brugada EKG. That leads to the ability to do genetic testing for Brugada, which is sometimes helpful.
Julie Hathaway: Most patients will have Brugada diagnosed on a simple EKG test. Sometimes, that EKG shows a clear Brugada pattern, and sometimes it shows what we call a partial Brugada pattern, which we sometimes also call a type 2 pattern.
Whenever we see a type 2 pattern, the best way we can know if that’s actually a real, clear Brugada pattern is by doing some extra testing. That extra testing is called a procainamide challenge, or a drug challenge, and it involves coming to the hospital and receiving a medication by IV, while we still track your heart rate, using an EKG, to see if we can bring out that clear Brugada pattern.
The test is quite uneventful, it doesn’t hurt, it’s just a way for us to see whether that type 2, or maybe Brugada ECG pattern is actually a clear or a real Brugada pattern. Whenever we see a clear Brugada pattern, either on a simple EKG, or following a procainamide or drug challenge test, we can offer a patient a blood test called a genetic test.
That’s a test that goes in and looks for any errors in the genetic material that may have caused that Brugada pattern to happen or show up. That genetic test becomes an important piece of information for that patient’s family members and helps in their diagnosis as well. Dr. Andrew Krahn: There’s two kinds of treatments for Brugada. Since most patients are perfectly well, there’s a simple precaution of certain medications that they should avoid, and the treatment of things like fever, and keeping in touch with their doctor to report if they have a fainting spell or a seizure.
In the small number of people who are more troubled by Brugada, where they’ve collapsed or fainted, those people typically have aggressive treatment with something like an implantable defibrillator or ICD. If you or someone in your family is concerned about the possibility of Brugada, please go see your doctor, who may refer you to a local heart specialist.