Treatment of Brugada Syndrome
Treatment of Brugada syndrome aims to prevent sudden cardiac death by controlling arrhythmias and reducing triggers. The main approaches in treatment of Brugada syndrome include lifestyle modifications, medication, and, in high-risk cases, an implantable cardioverter-defibrillator (ICD).
The first line of defence is identifying and avoiding known triggers. PDoctors advise patients to avoid specific medications that can worsen Brugada ECG patterns. This includes some antiarrhythmics, tricyclic antidepressants, antihistamines, and anaesthetics. Patients should review a complete list of risky medications with their cardiologist.
Fever management is crucial. Fever can unmask or exacerbate ECG changes and trigger dangerous arrhythmias. Doctors recommend giving antipyretics like paracetamol at the first sign of fever, especially for children with known Brugada syndrome.
Doctors often recommend an ICD for high-risk patients, such as those with a history of cardiac arrest, fainting, or a spontaneous type 1 ECG pattern. This small device continuously monitors the heart’s rhythm and delivers a shock if it detects a life-threatening arrhythmia. It does not prevent arrhythmias from occurring but effectively treats them when they do.
Doctors may use quinidine, an antiarrhythmic drug, in some cases to reduce arrhythmia episodes. Doctors often consider quinidine for patients who cannot get an ICD or who experience frequent shocks from their device.
Lifestyle changes include avoiding excessive alcohol, staying well hydrated, managing stress, and ensuring good sleep. These steps help lower the chances of triggering dangerous arrhythmias.
Treatment of Brugada Syndrome
For asymptomatic patients with a Brugada ECG pattern but no history of fainting or family history of sudden death, careful monitoring may be sufficient. These individuals are generally not given ICDs unless their risk profile changes.
Regular follow-ups with a cardiologist, possibly a specialist in inherited cardiac conditions, are essential. Treatment plans should be updated based on new symptoms, family screening results, or evolving risk factors.
Successful treatment of Brugada syndrome focuses on prevention, education, and readiness — giving patients the tools to manage their condition and reduce life-threatening risk.
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