Brugada syndrome: two decades of progress

Circ J. 2012;76(12):2713-22. doi: 10.1253/circj.cj-12-1352. Epub 2012 Nov 14.


Two decades ago, a series of 8 idiopathic ventricular fibrillation patients who each had an abnormal ECG (right bundle branch block with coved-type ECG), but otherwise had normal hearts were described by Brugada and Brugada. Since then, the clinical entity has become known as Brugada syndrome (BS). Shortly thereafter, mutations of the SCN5A gene that encodes for the α-subunit of the sodium channel were found, galvanizing the field of ion channelopathies following in the footsteps of the breakthrough in long QT syndrome. Over the past 20 years, extensive research in this field has produced major progress toward better understanding of BS and the gaining of knowledge of the genetic background, pathophysiology and new management. Two consensus reports were published to help define the diagnostic criteria, risk stratification and management of BS patients. However, there are controversies. In this review, we will share our experiences of BS patients in Thailand and discuss advances in many aspects of the syndrome (ie, genetics and pathophysiology) and some of these pertinent controversies, as well as new treatment of the syndrome with catheter ablation.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Arrhythmia Agents / therapeutic use
  • Brugada Syndrome* / diagnosis
  • Brugada Syndrome* / epidemiology
  • Brugada Syndrome* / genetics
  • Brugada Syndrome* / physiopathology
  • Brugada Syndrome* / therapy
  • Catheter Ablation
  • Defibrillators, Implantable
  • Electric Countershock / instrumentation
  • Electrocardiography
  • Electrophysiologic Techniques, Cardiac
  • Genetic Predisposition to Disease
  • Heart Conduction System / physiopathology
  • Humans
  • Mutation
  • NAV1.5 Voltage-Gated Sodium Channel / genetics
  • Phenotype
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors
  • Thailand / epidemiology
  • Treatment Outcome


  • Anti-Arrhythmia Agents
  • NAV1.5 Voltage-Gated Sodium Channel
  • SCN5A protein, human