28 Nov 2023 • What is the long-term prognosis of asymptomatic patients with Brugada electrocardiogram (ECG) pattern (BrECG)? Controversies surrounding the management of asymptomatic patients with a Brugada pattern on ECG were addressed in a recent study with a follow-up period of 6yrs.

Results indicated a low overall event rate of 0.2% per year. The presence of a spontaneous type-1 Brugada ECG, coupled with a positive EP study, signaled a higher arrhythmic risk, while asymptomatic patients with drug-induced–only BrECG carried minimal risk.

The authors conclude that the entire population of asymptomatic patients with BrECG exhibits a low event rate. It is important to remember that patients with a positive drug test should be provided with lifesaving behavioral recommendations and made aware of the need for regular follow-up visits, each with repeat ECGs and 12-lead 24-hour Holter monitoring to detect the appearance of a spontaneous type-1 BrECG pattern.

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