Drug Challenge In Brugada Syndrome: How Valuable Is It?

In patients with structurally normal hearts and unexplained syncope or cardiac arrest, Brugada syndrome is considered a frequent underlying condition. In patients with suspected Brugada syndrome but inconclusive or normal ECG findings at baseline, drug challenge with intravenous administration of sodium channel blockers according to a standardised protocol is a powerful tool to unmask diagnostic type-1 Brugada ECG features and thereby identify patients at risk of sudden death. The additional impact of drug challenge in the risk stratification algorithms of patients already diagnosed with Brugada syndrome is less well-established and requires additional studies.