Brugada syndrome - minimizing overdiagnosis and over treatment in children

Area of Science:

• Pediatric Cardiology
• Clinical Electrophysiology
• Genetic Heart Diseases

Background:

• Brugada syndrome (BrS) presents unique challenges in pediatric populations.
• Manifestations range from asymptomatic family history referrals to rare early clinical presentations.
• Understanding pediatric BrS is crucial for timely and appropriate management.

Purpose of the Study:

• To review current contributions to understanding Brugada syndrome in early life.
• To cover screening of asymptomatic children with family history and symptomatic children.
• To address diagnostic and risk stratification challenges in pediatric BrS.

Main Methods:

• Review of current literature on pediatric Brugada syndrome.
• Inclusion of controversial diagnostic and risk stratification aspects.
• Discussion of noninvasive (Holter, exercise tests, ILR, provocative tests) and invasive methods.
• Commentary on genetic testing in the pediatric age group.

Main Results:

• Pediatric BrS has distinct features, including risks associated with family history of sudden cardiac death and syncope.
• Diagnostic challenges are significant in this age group.
• Controversial aspects of diagnosis and risk stratification were examined, including various testing modalities.

Conclusions:

• Systematic and individualized assessment is key to minimizing overdiagnosis and overtreatment in young patients.
• Development of appropriate diagnostic guidelines and age-specific risk stratification algorithms is needed.
• This approach ensures better management for suspected and confirmed pediatric Brugada syndrome.