title: Risk Stratification and Therapeutic Approach in Brugada Syndrome.
abstract: Brugada syndrome (BrS) is a clinical entity characterised by an incomplete right bundle branch block associated with an ST segment elevation in the right precordial leads and a risk of ventricular arrhythmia and sudden death in the absence of structural abnormalities. Patients with a personal history of sudden death have an annual arrhythmia risk of recurrence as high as 10 %. Similarly, the presence of syncope is consistently associated with an increased arrhythmic risk. This risk can be estimated at about 1.5 % per year. The risk is lower in asymptomatic patients. Regarding the relatively high rate of complication of Implantable cardioverter defibrillator (ICD) implantation, in most of the cases, asymptomatic patients with a Brugada syndrome revealed during ajmaline challenge do not need to be implanted. The situation is more complex in patients with a spontaneous type 1 aspect since the risk could be estimated to be around 0.8 % per year. For these patients, a careful evaluation of the arrhythmic risk using all the different tools available is mandatory.
authors.affiliation: Professor of Cardiology and Head of Reference Centre for Hereditary Arrhythmia.
authors.forename: Vincent
authors.initials: V
authors.lastname: Probst
authors.affiliation: Project Manager.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Chatel
authors.affiliation: Assistant Professor.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Gourraud
authors.affiliation: Professor of Cardiology and Head, Thorax Institute, Nantes, France.
authors.forename: Hervé Le
authors.initials: HL
authors.lastname: Marec
keywords: Brugada syndrome; arrhythmias; genetic; risk stratification; sudden death
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