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Brugada Syndrome — RACP Adult Medicine MCQ

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HardCardiologyBrugada SyndromeRACP Adult Medicine

A 55-year-old man with known Brugada syndrome (type 1 pattern on ECG) has a history of syncope but no documented arrhythmias. His brother died suddenly at age 40. EPS shows inducible sustained VT. What is the most appropriate management?

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Correct answer: B — ICD implantation

Brugada syndrome with type 1 ECG pattern, syncope, and inducible VT on EPS places this patient at high risk of sudden cardiac death. ICD implantation is the most effective prevention of SCD in Brugada syndrome. Quinidine may be used as adjunctive therapy or in patients who decline/cannot have an ICD. Class IC antiarrhythmics (flecainide) are contraindicated.

Reference: ESC – 2022 – Ventricular Arrhythmia/SCD Guidelines; CSANZ 2024