Clinical Management of Brugada Syndrome: Commentary From the Experts

Area of Science:

• Cardiology
• Electrophysiology
• Genetics

Background:

• Brugada Syndrome management guidelines primarily address high-risk patients.
• Asymptomatic or intermediate-risk Brugada Syndrome patients pose significant clinical challenges.
• Current guidelines offer limited direction for nuanced Brugada Syndrome cases.

Purpose of the Study:

• To explore global expert opinions on managing Brugada Syndrome patients outside standard guidelines.
• To identify consensus and controversies in diagnosing and treating complex Brugada Syndrome cases.
• To highlight knowledge gaps in Brugada Syndrome management for challenging patient profiles.

Main Methods:

• Presentation of four real-world clinical scenarios involving Brugada Syndrome.
• Commentary and discussion by small, international expert groups for each case.
• Author voting on case-specific questions to assess consensus on diagnostic and management decisions.

Main Results:

• Identified specific areas of expert agreement regarding Brugada Syndrome management.
• Highlighted key points of controversy in the diagnostic and therapeutic approaches.
• Revealed significant gaps in current knowledge for managing complex Brugada Syndrome patients.

Conclusions:

• Expert consensus exists for some aspects of Brugada Syndrome management in challenging cases.
• Significant controversies remain, indicating a need for further research and guideline refinement.
• Addressing knowledge gaps is crucial for optimizing care for all Brugada Syndrome patients.