Clinical Management of Brugada Syndrome: Commentary From the Experts

Author:

Cutler Michael J.1ORCID,Eckhardt Lee L.2ORCID,Kaufman Elizabeth S.3ORCID,Arbelo Elena456ORCID,Behr Elijah R.78ORCID,Brugada Pedro910ORCID,Cerrone Marina11ORCID,Crotti Lia1213ORCID,deAsmundis Carlo14ORCID,Gollob Michael H.15ORCID,Horie Minoru16ORCID,Huang David T.17ORCID,Krahn Andrew D.18ORCID,London Barry19ORCID,Lubitz Steven A.20ORCID,Mackall Judith A.21ORCID,Nademanee Koonlawee2223ORCID,Perez Marco V.24ORCID,Probst Vincent25ORCID,Roden Dan M.26ORCID,Sacher Frederic27ORCID,Sarquella-Brugada Georgia2829ORCID,Scheinman Melvin M.30ORCID,Shimizu Wataru31ORCID,Shoemaker Benjamin32ORCID,Sy Raymond W.3334ORCID,Watanabe Atsuyuki35,Wilde Arthur A.M.3637ORCID

Affiliation:

1. Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT (M.J.C.).

2. Cellular and Molecular Arrhythmia Research Program, Division of CVM, Department of Medicine, University of Wisconsin-Madison (L.L.E.).

3. Heart and Vascular Center, MetroHealth Campus, Case Western Reserve University, Cleveland, OH (E.S.K.).

4. Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona (E.A.).

5. Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid (E.A.).

6. IDIBAPS, Institut d’Investigacio August Pi I Sunyer, Barcelona, Spain (E.A.).

7. Cardiovascular Clinical Academic Group, Cardiology Section, St. George’s, University of London and St. George’s University Hospitals NHS Foundation Trust (E.R.B.).

8. Mayo Clinic Healthcare, London, United Kingdom (E.R.B.).

9. Cardiovascular Division, UZ Brussel-VUB, Belgium (P.B.).

10. Arrhythmia Unit, Helicopteros Sanitarios Hospital (HSH), Puerto Banús, Marbella, Malaga, Spain (P.B.).

11. New York Univ Grossman School of Medicine, Leon H. Charney Division of Cardiology (M.C.).

12. Department of Medicine and Surgery, University of Milano-Bicocca (L.C.).

13. Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Milan, Italy (L.C.).

14. Heart Rhythm Management Center, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Belgium (C.D.).

15. Peter Munk Cardiac Center, Division of Cardiology, Toronto General Hospital, University Health Network, Canada (M.H.G.).

16. Department of Cardiovascular Medicine, Shiga University of Medical Science, Ohtsu, Japan (M.H.).

17. University of Rochester Medical Center, NY (D.T.H.).

18. Center for Cardiovascular Innovation, Division of Cardiology, University of British Columbia, Vancouver, Canada (A.D.K.).

19. Division of Cardiovascular Medicine, Department of Internal Medicine and Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City (B.L.).

20. Demoulas Center for Cardiac Arrhythmias, Massachusetts General Hospital, Boston (S.A.L.).

21. Department of Medicine, Division of Cardiology, University Hospitals Harrington Heart and Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, OH (J.A.M.).

22. Center of Excellence in Arrhythmia Research, Department of Medicine, Faculty of Medicine, Chulalongkorn University (K.N.).

23. Pacific Rim Electrophysiology Research Institute at Bumrungrad Hospital, Bangkok, Thailand (K.N.).

24. Stanford Center for Inherited Cardiovascular Diseases, Stanford University, CA (M.V.P.).

25. Université Nantes, CHU Nantes, CNRS, INSERM, Service de Cardiologie, l’institut du thorax, Nantes, France (V.P.).

26. Departments of Medicine, Pharmacology and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN (D.M.R.).

27. Arrhythmia Department, Bordeaux University Hospital, IHU LIRYC, Pessac, France (F.S.).

28. Pediatric Arrhythmias, Inherited Cardiac Diseases and Sudden Death Unit, Hospital Sant Joan de Déu, Universitat de Barcelona (G.S.-B.).

29. Arrítmies Pediàtriques, Cardiologia Genètica i Mort sobtada, Malalties Cardiovasculars en el Desenvolupament, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain (G.S.-B.).

30. Section of Cardiac Electrophysiology, Division of Cardiology, University of California-San Francisco (M.M.S.).

31. Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan (W.S.).

32. Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN (B.S.).

33. Faculty of Medicine and Heath, The University of Sydney (R.W.S.).

34. Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia (R.W.S.).

35. Department of Cardiology, National Hospital Organization Okayama Medical Center, Japan (A.W.).

36. Department of Cardiology, University of Amsterdam (A.A.M.W.).

37. Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands (A.A.M.W.).

Abstract

Although there is consensus on the management of patients with Brugada Syndrome with high risk for sudden cardiac arrest, asymptomatic or intermediate-risk patients present clinical management challenges. This document explores the management opinions of experts throughout the world for patients with Brugada Syndrome who do not fit guideline recommendations. Four real-world clinical scenarios were presented with commentary from small expert groups for each case. All authors voted on case-specific questions to evaluate the level of consensus among the entire group in nuanced diagnostic and management decisions relevant to each case. Points of agreement, points of controversy, and gaps in knowledge are highlighted.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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