{"id":189,"date":"2024-06-23T21:30:50","date_gmt":"2024-06-23T19:30:50","guid":{"rendered":"https:\/\/grossicardiologo.it\/?p=189"},"modified":"2026-03-20T15:45:25","modified_gmt":"2026-03-20T14:45:25","slug":"trattamenti-della-sindrome-di-brugada","status":"publish","type":"post","link":"https:\/\/grossicardiologo.it\/en\/trattamenti-della-sindrome-di-brugada\/","title":{"rendered":"What Are the Treatments for Brugada Syndrome?"},"content":{"rendered":"
<\/div><\/div>\n\n\n\n

Here are the treatments for Brugada Syndrome<\/strong><\/a> performed by Dr. Stefano Grossi<\/a>.<\/p>\n\n\n

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Low-Risk Patients<\/h2>\n\n\n\n

For patients considered low-risk, preventing adverse events involves lifestyle modifications.\nAll patients with Brugada Syndrome should receive a detailed list of medications to avoid\n(available at www.brugadadrugs.org).<\/p>\n\n\n\n

Key recommendations include:\nAvoid the use of recreational drugs, particularly cocaine, as well as excessive amounts\nof alcohol and food.\nPromptly address fever with paracetamol or ice, as elevated temperatures above\n37.5\u00b0C can inhibit sodium channels and promote arrhythmias.<\/p>\n<\/div><\/div>\n\n\n\n

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Pay attention to food and alcohol intake<\/figcaption><\/figure>\n<\/div><\/div>\n\n<\/div><\/div>\n\n
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Fig 3: transvenous defibrillator on the left, subcutaneous defibrillator on the right.<\/figcaption><\/figure>\n<\/div><\/div>\n\n\n\n
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High-Risk Patients<\/h2>\n\n\n\n

For high-risk patients, including those who have experienced significant events such as\nsyncope with spontaneous Type 1 pattern, aborted cardiac arrest, or documented major\nspontaneous or induced ventricular arrhythmias during electrophysiological study, the\nimplantation of a defibrillator is recommended. The defibrillator delivers a life-saving\nelectrical shock in the event of severe ventricular arrhythmias (see Fig. 3).<\/p>\n\n\n\n

Considerations:\nWhile defibrillators prevent sudden death, they can pose challenges, such as:\no Painful shocks, sometimes triggered by non-serious arrhythmias.\no Malfunctions or infections that may necessitate removal of the device, a\nprocedure with inherent risks.\n\nSubcutaneous defibrillators reduce, but do not entirely eliminate, these complications.<\/p>\n<\/div><\/div>\n\n<\/div><\/div>\n\n

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Intermediate-Risk Patients<\/h2>\n\n\n\n

For intermediate-risk patients, pharmacological treatment may be considered. The drug of\nchoice is quinidine, a Class IA antiarrhythmic that blocks potassium channels. Clinical\nstudies demonstrate its efficacy in preventing arrhythmic recurrences in 70\u2013100% of cases.\nQuinidine Side Effects:\nPrevalence: Side effects occur in 20\u201340% of patients.\nCommon Issues: Thrombocytopenia, diarrhea, esophagitis, allergic reactions, QTc\nprolongation, and torsades de pointes.\nDiscontinuation Rate: About 30% of patients stop the drug due to side effects.<\/p>\n<\/div><\/div>\n\n\n\n

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Pharmacological treatment for intermediate-risk patients.<\/figcaption><\/figure>\n<\/div><\/div>\n\n<\/div><\/div>\n\n\n
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This page describes the standard clinical protocols<\/h2>\n\n\n\n

(medications, prevention, defibrillator).<\/h6>\n\n\n\n

If you are looking for an advanced therapeutic solution<\/strong> or want to evaluateAblation<\/strong> as a definitive alternative to medications and the defibrillator:<\/p>\n\n\n\n

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GO TO THE CARE AND ABLATION PATHWAY<\/strong><\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n
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Treatments<\/h2>\n<\/div>\n\n\n
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\"trattamenti
Catheter ablation<\/figcaption><\/figure>\n<\/div><\/div>\n\n\n\n
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In 2011, electrophysiologist Nadamanee identified a region in the right ventricular outflow\ntract, located beneath the epicardium, as the source of electrophysiological abnormalities\nresponsible for Brugada Syndrome.<\/p>\n\n\n\n

Ablation Procedure:<\/p>\n\n\n\n

An ablation catheter is inserted into the pericardium, the protective sac surrounding\nthe heart.\nThe abnormal cells, identifiable by their distinct electrical potentials, are destroyed\nusing radiofrequency energy.\nThis eliminates abnormal electrical signals on the heart\u2019s surface, resolves the Type 1\nECG pattern, and eliminates the arrhythmic substrate.\nA follow-up electrophysiological study confirms the absence of inducible arrhythmias\nat the end of the procedure.<\/p>\n\n\n\n

This approach is highly effective in the elimination of the electrophysiological substrate of\nBrugada Syndrome.<\/p>\n<\/div><\/div>\n\n<\/div><\/div>\n\n\n

<\/div>\n\n\n\n

For more complex cases, Dr. Grossi performs<\/em>Brugada Syndrome ablation using robotic technology<\/a><\/strong>, a procedure in which he is an international pioneer.<\/em><\/p>\n\n\n\n

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The disappearance of the Type 1 pattern must be evident at the end of the procedure and\nconfirmed after at least one month, both under baseline conditions and with an ajmaline\nprovocative test.<\/p>\n\n\n\n

At this point, the ablative treatment can be considered effective.<\/p>\n\n\n\n

Numerous studies on ablation for Brugada Syndrome have shown excellent results, with the\ndisappearance of the Type 1 pattern and absence of ventricular arrhythmias in over 80% of\ncases after the first procedure and in 96% of treated patients, with an intraprocedural\ncomplication rate below 2%.<\/p>\n\n\n\n

Summary<\/h2>\n\n\n\n

In summary, for Brugada Syndrome, a defibrillator is deemed necessary for patients at high\nrisk of sudden death. If arrhythmic episodes are frequent, defibrillator interventions can be\nminimized with quinidine. When quinidine is not tolerated or when lifelong medication is\nundesirable, ablation\u2014which addresses the arrhythmia's root cause\u2014has shown high\nefficacy.\nCollected data will soon clarify whether ablative treatment can be considered effective\nenough for high-risk patients to avoid defibrillator implantation.<\/p>\n\n\n\n

For patients where the risk does not justify a defibrillator due to its potential consequences,\ncertain subgroups may still have a non-negligible risk. Asymptomatic patients with a\nspontaneous Type 1 pattern have an annual arrhythmic event risk 100 times higher than\nunaffected individuals. In such cases, ablation can significantly reduce this risk without\nrequiring a defibrillator or continuous medication.\nThe same reasoning applies to asymptomatic patients with a family history of sudden death or\ninducible arrhythmias during an electrophysiological study.\nTreatment must always be individualized and discussed collaboratively between doctor and\npatient, emphasizing an effective doctor-patient alliance.<\/p>\n<\/div><\/div>\n\n<\/div><\/div>\n\n

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Il Dott. Stefano Grossi ha eseguito ad oggi pi\u00f9 di 200 ablazioni in pazienti affetti da sindrome di Brugada , la sua \u00e8 a tutt\u2019oggi la seconda casisistica al mondo.<\/strong><\/p>\n\n\n\n

In 2018, he performed, for the first time in Italy, an ablation procedure for Brugada syndrome using the Stereotaxis robotic magnetic navigation system.<\/strong><\/p>\n<\/div><\/div>\n\n<\/div><\/div>\n\n\n

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What is Brugada Syndrome?<\/h2>\n\n\n\n
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Learn more<\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n
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Ablation of Brugada Syndrome<\/h2>\n\n\n\n
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Learn more<\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n

<\/p>","protected":false},"excerpt":{"rendered":"

Ecco i trattamenti della Sindrome di Brugada praticati dal dr. Stefano Grossi. Pazienti a basso rischio Quando il paziente viene considerato a basso rischio la prevenzione degli eventi avversi si pu\u00f2 limitare ad una modificazione dello stile di vita. Tutti i pazienti con sindrome di Brugada devono ricevere una lista dei farmaci da evitare scrupolosamente […]<\/p>\n","protected":false},"author":1,"featured_media":168,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-189","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-trattamenti"],"yoast_head":"\nSindrome di Brugada: Centri d'Eccellenza e Trattamenti - Dr. Grossi<\/title>\n<meta name=\"description\" content=\"Scopri le terapie pi\u00f9 avanzate per la Sindrome di Brugada, dall'impianto di defibrillatore all'ablazione epicardica. 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