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From bench to practice: the Brugada syndrome

Session presentations
Sudden Cardiac Death and Resuscitation

In the From Bench to Practice: the Brugada syndrome symposium, the most recents advances in this condition were reviewed.

Dr. Husser analyzed the latest mutations discovered so far, basically on the MOG1 gene and how some polymorphisms like H558R might act as specific therapy restoring defective trafficking of the channels to the membrane. Dr. Gaita reviewed all different ECG characteristics of Brugada syndrome patients, and especially the atypical forms that might be difficult to identify, fluctuations in the abnormalities, changes in the characteristics depending on the position of the electrodes in the chest and how drug testing can be used.

Dr. Goette analyzed the value of several characteristics in risk stratification, clinical data, previous symptoms, ECG pattern and fragmentation, inducibility, ventricular refractory period using information of two recent studies, namely the FINGER and PRELUDE studies. Finally, Dr. Mabo reviewed the most recent information in drug therapy using Quinidine, Isoproterenol, Procainamide or Cilostazol. He also reviewed information about ablation of the initiating extrasystoles or of the substrate in the right ventricular outflow tract epicardium using ventricular fibrillation inducibility as an end point.

Once agreement between different groups has been reached in the clinical characteristics as in the prognostic risk factors (basal ECG, previous symptoms), many of the characteristics that are now being investigated and discussed have a lot to do with the substrate and electrophysiology of the disease: ECG fragmentation, refractory period, inducibility.

Overall, the session showed that we have advanced tremendously in the knowledge about Brugada syndrome but still there is a long way to go to fully understand the disease.




From bench to practice: the Brugada syndrome

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.