[SCD-FORUM] 6E RE: Brugada syndrome. Dr. Ramon Brugada

[SCD Symposium]

Dear Dr Arenzo:
In the individual with type I ecg, there is no need for an ajamline  
test,
the diagnosis is made. If the ecg is "type II or III" (non-diagnostic),
ajmaline test is recommended.

You will find all the options available in how to deal with the  
asymptomatic
patient with type I ecg.


-          follow-up until he develops symptoms.

-          ICD implantation, especially if there is a remote  
possibility of
sudden cardiac death in the family

-          EPS as tool for risk stratification. A positive non- 
aggressive
EPS is very indicative of a patient with an increased risk for
arrhythmogenecity.

A negative EPS in the sporadic individual is indicative of good  
prognosis.


As you well know, the use of EPS to risk stratify asymptomatic  
patients is
very controversial. However, the first two options are not perfect. The
first symptom may be sudden death, and ICD is not free of collateral
problems and certainly not an easy decision for an asymptomatic 40  
year old
.

Thank you


Ramon Brugada MD FACC
Associate Professor of Medicine
Canadian Research Chair Genetics of Arrhythmias
University of Montreal
Director Clinical Cardiovascular Genetics Center
Montreal Heart Institute
5000 Rue Belanger
Montreal, QC H1T 1C8
Canada
ramon at brugada.org

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee




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