Treatments and drugs

By Mayo Clinic Staff

Brugada syndrome treatment depends on the risk of an abnormal heartbeat (arrhythmia). Those considered at high risk have:

  • A personal history of serious heart rhythm problems
  • A personal history of fainting spells
  • A personal history of survived sudden cardiac arrest

Because of the nature of the heart rhythm abnormality, medications usually aren’t used to treat Brugada syndrome. A medical device called an implantable cardioverter-defibrillator is the main treatment.

  • Implantable cardioverter-defibrillator (ICD). For high-risk individuals, treatment may include an implantable cardioverter-defibrillator (ICD). This small device continuously monitors your heart rhythm and delivers electrical shocks when needed to control abnormal heartbeats.

    To place an ICD, a flexible, insulated wire (lead) is inserted into a major vein under or near your collarbone and guided, with the help of X-ray images, to your heart.

    The ends of the leads are secured to your heart's bottom pumping chambers (ventricles), while the other ends are attached to the shock generator, which is usually implanted under the skin beneath your collarbone. The procedure to implant an ICD requires hospitalization for a day or two.

    ICDs may cause complications, some life-threatening, so it's important to weigh the benefits and the risks. People who have an ICD implanted as a treatment for Brugada syndrome have reported receiving shocks from their ICD even when their heartbeat was regular.

    Your doctor will program your ICD to reduce this risk. If you have an ICD implanted as part of your Brugada syndrome treatment, talk to your doctor about ways to avoid inappropriate shocks.

  • Drug therapy. Sometimes, medications such as quinidine are used to prevent the heart from going into its potentially dangerous rhythm. It may also be helpful as a supplemental therapy for people who already have an ICD.

    However, if the patient is at high risk because of a prior cardiac arrest or a concerning fainting episode, the main treatment is ICD implantation.

April 19, 2014