Treatment of the Patient with Brugada Syndrome – a Case Report

Aim: Brugada syndrome is a rare genetic disorder that can be recognized by characteristic changes in ECG records. The syndrome is more common in Southeast Asian countries than in the rest of the world. Considering the increasing presence of foreign workers from Southeast Asia in Europe, this work aims to draw attention of healthcare professionals and educate them on early recognition and prompt stratification of patients at risk. Case report: This paper presents the case of a patient hospitalized due to out-of-hospital cardiac arrest. After hemodynamic stabilization at the emergency department, ECG showed changes indicative of Brugada pattern type 1. Cardiac arrest soon occurred again due to polymorphic ventricular tachycardia. This time, despite numerous defibrillations and therapy, the return of spontaneous circulation was not achieved initially. The electrical storm was finally terminated by the administration of isoproterenol, a β-adrenoreceptor agonist recommended by the Guidelines of the European Society of Cardiology. In the further course, the hospital stay, development of complications, their treatment, and the implantation of a cardioverter defibrillator in secondary prevention are described. Conclusion: The specificity of this syndrome is the increased risk of sudden cardiac death in healthy and young individuals, mostly men. The Guidelines give clear recommendations on the management of symptomatic patients, as well as those with Brugada pattern type 1. No clear guidelines are given for pattern types 2 and 3. Therefore, the consensus of experts expressed in the Shanghai scoring system can be used for risk stratification and further treatment. It is of great importance to recognize ECG records with the Brugada pattern and to promptly refer the patient for further evaluation with the aim of primary prevention of sudden cardiac death.