Amid the fourth lustrum after the description of Brugada syndrome: controversies over?

Abstract

Since the description in 1992 of the syndrome or right bundle branch block, persistent ST segment elevation, and sudden cardiac death,1 almost every single aspect of what has become known as Brugada syndrome has been disputed during these 17 years: from diagnostic criteria, electrocardiographic manifestations, pathologic findings, electrophysiological mechanisms, genetic data (including the true incidence and value of mutations and polymorphisms) to the value of numerous techniques for the diagnosis, assessment of prognosis, and therapeutic decision-making. It has been only after years of studies that some aspects of the disease have become scientifically evident and accepted by the medical community. (i) Brugada syndrome is a distinct disease with a genetic background with various mutations leading to a similar electrocardiographic and clinical phenotype. (ii) Other diseases and conditions may result in the same electrocardiographic manifestations2 and need to be excluded before accepting the diagnosis of Brugada disease. (iii) Brugada syndrome … *Corresponding author. Tel: +32 53 724 439, Fax: +32 53 724 185, Email: pedro{at}brugada.org