Patients with Brugada syndrome will sometimes have a family history of sudden cardiac death and a personal history of of arrhythmias. If patients are symptomatic they often have symptoms of syncope, seizures, agonal breathing, difficulty breathing, and patients may even present with sudden death. These symptoms most often come on either at rest or during sleep.

• Brugada syndrome is diagnosed when a Type 1 ST-segment elevation is observed in more than one right precordial lead (V1-V3), in the presence or absence of sodium channel blocking agent, in conjunction with one or more of the following:

1. Family history of sudden cardiac death (SCD) (<45 years old)
2. Documented ventricular fibrillation (VF)
3. Polymorphic ventricular tachycardia
4. Coved-type ECG changes in family members
5. Inducibility of ventricular tachycardia (VT) with programmed electrical stimulation (PES)

• The diagnosis is also considered positive when a Type 2 (saddleback pattern) or Type 3 ST-segment elevation is observed in more than one right precordial lead under baseline conditions and can be converted to the diagnostic Type 1 pattern occurs upon exposure to a sodium channel blocker.

These complications typically occur when an affected person is resting or asleep:

• Fainting
• Syncope
• Seizures
• Difficulty breathing
• Sudden death
• Agonal breathing

Cardiology