Risk stratification in brugada syndrome: Clinical characteristics, electrocardiographic parameters and auxiliary testing

Management of patients with Brugada syndrome is dependent on risk stratification. Patients with only a drug-induced Brugada pattern and without any other risk markers are at very low risk and are usually followed without treatment. Survivors of a cardiac arrest are at the highest risk of cardiac events and are usually managed with implantable cardioverter-defibrillators. Patients with history of syncope are at intermediate risk. Their risk stratification is dependent, first and foremost, on the presumed cause of loss of consciousness (arrhythmic or non-arrhythmic). However, most Brugada patients are asymptomatic. Their risk is low but not trivial. Therefore, most efforts for risk stratification focus on this group. Unfortunately, a widely-accepted risk stratification strategy is unavailable. Most controversy revolves around the issue of programmed electrical stimulation and its effectiveness in predicting cardiac events. In this chapter the current data regarding risk stratification of Brugada syndrome will be discussed and an approach to patients suggested.