HRS Board Review 2025 New Courses (Reviewers Copy)-Workshop 1_Electrocardio_London_2025

Video Transcription

Case two, a 47-year-old man with a history relevant to two prior syncopal events comes to you after his 38-year-old brother was resuscitated following a cardiac arrest.  His brother was diagnosed with Brugada syndrome and a defibrillator was placed. The right precordial leads of your patient's ECG are shown below. This shows leads V1 and V2.  The next best step is A, implantation of a defibrillator,  B, genetic testing of your patient, C, reassurance as your patient is beyond the age at which he is at risk for developing clinical Brugada syndrome,  D, an IV procainamide challenge, and E, electrophysiology testing with programmed electrical stimulation looking for inducible ventricular fibrillation.

Video Summary

In this case, a 47-year-old man with a history of syncope visits after his brother, diagnosed with Brugada syndrome, had a cardiac arrest. Given the familial history and the information provided, the next step is often to conduct genetic testing for Brugada syndrome (option B), as the patient is at an age where risk is reduced, and ECG evidence suggests possible Brugada syndrome. This can help confirm the diagnosis and guide further management, including potential defibrillator implantation or additional testing. However, clinical guidelines and expert opinions are essential for a definitive approach.

Keywords

Brugada syndrome

genetic testing

syncope

familial history

cardiac arrest