At Cardiac Science, we strongly believe in raising awareness of all types of heart conditions. From the ultra-rare to the relatively common, we’re here to provide a basic understanding of any disorders that could potentially cause sudden cardiac arrest. Because ultimately, it might just help save a life one day.
Today, we’d like to highlight Brugada syndrome. Brugada syndrome is a rare but potentially dangerous heart rhythm disorder, which can cause the heart to beat abnormally quickly.
What causes Brugada syndrome?
The cause of Brugada syndrome is usually a faulty gene. This gene is passed down through families, and affects the way electrical signals pass through the heart.
It does this by disrupting the flow of sodium or potassium ions into the cells of the heart, causing the cells to become electrically ‘faulty’. This then disrupts the electrical signals that keep the heart beating, resulting in ventricular arrhythmia – or an abnormally fast heartbeat.
If you’re a man, you are more likely to have Brugada syndrome than a woman or child. Your risk is also higher if you have a parent, child, or sibling with Brugada syndrome, or a close family member who has died suddenly from an undiagnosed heart problem.
It is currently estimated that around 5 in 10,000 people has Brugada syndrome.
What are the symptoms of Brugada syndrome?
Brugada syndrome symptoms can include palpitations, blackouts, seizures, chest pain, breathlessness, dizziness, or even sudden cardiac arrest. These symptoms usually appear between the ages of 30 and 40, although they can start at any age.
That said, many people with Brugada syndrome don’t realise they have it. Symptoms might only present when they are dehydrated, have a high temperature, drink a large volume of alcohol, or take certain medicines (e.g. sodium blockers) – but otherwise they may live normal, healthy lives.
By avoiding these triggers, patients with the syndrome can reduce their risk of ventricular arrhythmia – and therefore the related symptoms of the condition.
How is Brugada syndrome diagnosed?
Brugada syndrome has a ‘tell-tale’ rhythm that can be picked up by an ECG, or electrocardiogram.
However, as the symptoms aren’t always obvious, patients with suspected Brugada syndrome are sometimes given a ‘ajmaline provocation test’. This is when a drug called ajmaline is taken through a drip, in order to temporarily bring out the symptoms of the condition. If the patient does not have Brugada syndrome, the ECG will show no significant changes – but if they do, the ‘tell-tale’ rhythm may appear.
Brugada syndrome can also be identified by genetic testing. However, scientists are still discovering new genes that can cause the condition – so if you have a previously undiscovered faulty gene, this method isn’t foolproof.
How do you treat Brugada syndrome?
Brugada syndrome treatments depend on your symptoms.
If you’ve already had a sudden cardiac arrest, or you have severe symptoms such as frequent blackouts, your doctor may advise you to have an implantable cardioverter-defibrillator or ‘ICD’ fitted.
This is a mini, matchbox-sized defibrillator which is fitted inside your chest. If your heart rhythm goes awry, the ICD will administer a tiny shock to correct it – helping to protect you from sudden cardiac arrest.
However, the majority of patients with Brugada syndrome have mild or no symptoms, and a low risk of developing dangerous heart rhythms.
So as long as they avoid the triggers mentioned above – by taking paracetamol when they have a fever, staying well-hydrated, avoiding certain medications, and not drinking too much alcohol – they should be able to live normal lives. If you’re interested, you can find a list of drugs people with Brugada syndrome should avoid here.
Brugada syndrome is a relatively new discovery, having only been identified in 1992. The genetic link wasn’t found until six years later, so scientists are still learning about the condition. As a result, the diagnosis and treatment of Brugada syndrome is still evolving.
So in the meantime, what can we do to help protect people with rare and undiagnosed heart conditions in our communities?
Well, at Cardiac Science, we believe the answer is two-fold. Part of it is about raising awareness of the signs, causes, and treatment of sudden cardiac arrest. And the other part is about ensuring every community has a public-access defibrillator nearby.