Brugada syndrome

Brugada syndrome is a rare genetic condition that can disrupt your heart rhythm.

In Brugada syndrome, there is a problem with the electrical activity in your heart. This can cause arrhythmias (abnormal heart rhythms).

Arrhythmias are dangerous, and can cause sudden cardiac arrest.

You may have Brugada syndrome without any symptoms.

If you have symptoms, they usually appear around the ages of 30 to 50 years. Symptoms can include:

• heart palpitations
• feeling dizzy or lightheaded
• fainting
• cardiac arrest, if your heart suddenly stops beating

Symptoms often come on at night or when resting.

Brugada syndrome is a genetic condition. It is inherited from one of your parents.

Some people with Brugada syndrome are more likely to have symptoms and arrhythmias with certain 'triggers'. These can include:

• having a fever
• taking some types of medicines
• drinking alcohol
• taking illicit drugs

If you have Brugada syndrome and you faint and then recover consciousness, seek urgent medical attention. Go to the emergency department of your local hospital.

If someone has collapsed with a cardiac arrest, call triple zero (000) and ask for an ambulance. (If calling triple zero (000) does not work on your mobile, try calling 112 — this number is only for mobile phones.)

Start CPR as soon as possible after calling for help — see here how to perform CPR.

Your doctor will ask about your symptoms and family medical history. They will do a physical examination.

Brugada syndrome is often diagnosed by an electrocardiogram (ECG) test showing the characteristic 'Brugada pattern'. Your doctor may identify this during a routine ECG test without you having any symptoms.

Other tests to look at your heart, such as an echocardiogram, may also be done.

Your doctor will refer you to a cardiologist (heart specialist) for further tests and treatment.

Sometimes a test is done where a specific medicine is given before an ECG. This is to see if it brings on changes in your ECG. This test is done in hospital so you can be monitored for symptoms and any problems can be treated quickly.

Genetic testing will also be recommended.

There are treatments available for Brugada syndrome. Your cardiologist will discuss the best treatment option for you.

Treatment may involve:

• avoiding triggers (medicines, drugs and alcohol)
• treating fevers promptly
• taking medicines to control your heart rhythm
• having a device implanted to treat arrhythmias
• having a procedure called 'radiofrequency catheter ablation' on your heart

An implantable cardioverter defibrillator (ICD) can be fitted. This device monitors your heart rhythm and can deliver an electric shock to your heart to control dangerous arrhythmias.

Your doctor will advise you of ways to reduce the chance of developing a dangerous abnormal heart rhythm.

You should:

• treat any fever promptly, especially in children — high body temperature increases the chance of complications
• mention your condition to your doctors before any surgery and before taking new medicines or supplements
• always check any new medicines with your doctor and pharmacist, including over-the-counter medicines
• avoid alcohol and illicit drugs
• have regular check-ups with your cardiologist

If you have Brugada syndrome and you suddenly faint or collapse, seek emergency medical attention.

The most serious complication of Brugada syndrome is sudden cardiac arrest. This is a medical emergency. Immediate medical attention is needed for survival.

Brugada syndrome is a genetic condition. If a family member has Brugada syndrome, your doctor may recommend genetic testing for the affected gene.

If you have the gene for Brugada syndrome, you have a 1 in 2 chance of passing the gene on to each of your children. If you are planning a pregnancy, it's a good idea to see a genetic counsellor.

Visit Hearts4Hearts for information about Brugada syndrome and implantable devices.

Visit the Heart Foundation to find more information about heart disease.

To find a genetic counsellor, visit the Australian Society for Genetic Counsellors.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.