Asymptomatic Brugada Patients: to Treat or Not

A 53 years old man was assisted to emergency department due to palpitations and presyncope. A ventricular tachycardia (VT) was documented and converted with intravenous lidocaine. He had history of sudden death in his two brothers. Type 1 electrocardiographic pattern of the Brugada syndrome was diagnosed (figure 1). Laboratory analysis, coronary angiography and echocardiogram were normal. Programmed electrical stimulation (PES) was induced the same VT (figure 2). A cardiodefibrillator (CD) was implanted and he suffered 8 episodes of ventricular flutter converted with the device in the 48 months follow up (figure 3).