All patients with suspected Brugada syndrome, based on the combination of symptoms and typical Brugada pattern ECG changes require an evaluation to exclude underlying structural heart disease.
Tests for identifying structural heart diseases: Echocardiogram and cardiac magnetic resonance imaging (MRI) may be undertaken as part of the full workup.
Provocation/ Challenge test: This is a test where Class I anti-arrhythmic medications (sodium channel blockers) are administered by cardiologists in an electrophysiological laboratory under controlled settings. Commonly used drugs are flecainide, procainamide, and ajmaline.
Learning bite
A typical ECG and a detailed history are important for the diagnosis of Brugada Syndrome. It is important to know that a normal ECG does not exclude the diagnosis of Brugada syndrome.