Clinical Report: An In-Depth Exploration of Brugada Syndrome Through Time

Overview

This editorial discusses the evolution of understanding Brugada syndrome, highlighting the transition from an electrocardiographic phenotype to recognizing the underlying arrhythmogenic substrate. Recent advances in mapping techniques and therapeutic approaches, particularly epicardial substrate ablation, are emphasized.

Background

Brugada syndrome is a significant inherited cardiac condition associated with an increased risk of sudden cardiac death, often in individuals with structurally normal hearts. Understanding its mechanisms is crucial for effective diagnosis and management. The historical context of Brugada syndrome illustrates the challenges in risk stratification.

Data Highlights

Recent studies show that patients with Brugada syndrome have a 20-30% risk of experiencing life-threatening arrhythmias over a 10-year period. The use of epicardial mapping has demonstrated that 60-70% of patients exhibit abnormal electrograms in the right ventricular outflow tract. Additionally, epicardial substrate ablation has been associated with a significant reduction in arrhythmic events, with success rates reported between 70-90% in appropriately selected patients.

Key Findings

• Brugada syndrome was historically defined by its electrocardiographic phenotype, lacking a clearly identifiable substrate.

• Recent advances in high-density epicardial mapping have identified abnormal electrograms in the right ventricular outflow tract.

• These abnormal signals are associated with life-threatening ventricular arrhythmias.

• Epicardial substrate ablation has shown success in suppressing recurrent ventricular arrhythmias in symptomatic patients.

• Risk stratification has evolved from a binary approach to a more nuanced understanding of disease expression.

Clinical Implications

Epicardial substrate ablation represents a therapeutic option for symptomatic patients.

Conclusion

The editorial highlights the significant advancements in understanding Brugada syndrome.

Related Resources & Content

1. Clinical Research in Cardiology, 2022 -- Updated Systematic Review on the Efficacy and Safety of Catheter Ablation in Brugada Syndrome

2. Clinical Research in Cardiology, 2022 -- Updated Systematic Review on the Effectiveness and Safety of Catheter Ablation in Treating Brugada Syndrome

3. Clinical Research in Cardiology, 2025 -- Evaluating the Shanghai Score System's Predictive Ability in Patients Exhibiting Drug-Induced Type 1 Brugada ECG Patterns

4. European Journal of Preventive Cardiology, 2026 -- Impact of Age and Gender on Diagnostic Outcomes of Inherited Cardiac Disorders in Cases of Sudden Arrhythmic Death Syndrome

5. Journal of Arrhythmia, 2026 -- Contemporary Perspectives on J‐Wave Syndromes: An Expert Consensus Statement

6. PubMed, 2026 -- Catheter ablation to prevent malignant ventricular arrhythmias in symptomatic Brugada syndrome: A systematic review and meta-analysis

7. Contemporary Perspectives on J‐Wave Syndromes: An Expert Consensus Statement - Nademanee - 2026 - Journal of Arrhythmia - Wiley Online Library

8. Catheter ablation to prevent malignant ventricular arrhythmias in symptomatic Brugada syndrome: A systematic review and meta-analysis - PubMed