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Circulation. 2005;111:659-670
Published online before print January 17, 2005, doi: 10.1161/01.CIR.0000152479.54298.51
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(Circulation. 2005;111:659-670.)
© 2005 American Heart Association, Inc.


Special Report

Brugada Syndrome: Report of the Second Consensus Conference

Endorsed by the Heart Rhythm Society and the European Heart Rhythm Association

Charles Antzelevitch, PhD; Pedro Brugada, MD, PhD; Martin Borggrefe, MD, PhD; Josep Brugada, MD; Ramon Brugada, MD; Domenico Corrado, MD, PhD; Ihor Gussak, MD, PhD; Herve LeMarec, MD; Koonlawee Nademanee, MD; Andres Ricardo Perez Riera, MD; Wataru Shimizu, MD, PhD; Eric Schulze-Bahr, MD; Hanno Tan, MD, PhD; Arthur Wilde, MD, PhD

From the Masonic Medical Research Laboratory, Utica, NY (C.A., R.B.); Cardiovascular Center, Cardiovascular Research and Teaching Institute, Aalst, Belgium (P.B.); University of Heidelberg, University Hospital of Mannheim, Mannheim, Germany (M.B.); Cardiovascular Institute, Clinical Hospital, University of Barcelona, Barcelona, Spain (J.B.); Divisione di Cardiología, Università di Padova, Padova, Italy (D.C.); eResearch Technology, Inc, Bridgewater, NJ (I.G.); Chu de Nantes, Nantes, France (H.L.); Pacific Rim Electrophysiology Research Institute, Inglewood, Calif (K.N.); ABC’s Faculty of Medicine, ABC Foundation, Santo André, São Paulo, Brazil (A.R.P.R.); National Cardiovascular Center, Suita, Japan (W.S.); Department of Cardiology, University of Münster, and Institute for Arteriosclerosis Research, Münster, Germany (E.S.-B.); and Experimental and Molecular Cardiology Group, Academic Medical Center, Amsterdam, and the Interuniversity Cardiology Institute, Utrecht, the Netherlands (H.T., A.W.).

Correspondence to Dr Charles Antzelevitch, Gordon K. Moe Scholar, Masonic Medical Research Laboratory, 2150 Bleecker St, Utica, NY 13501. E-mail ca{at}mmrl.edu

Since its introduction as a clinical entity in 1992, the Brugada syndrome has progressed from being a rare disease to one that is second only to automobile accidents as a cause of death among young adults in some countries. Electrocardiographically characterized by a distinct ST-segment elevation in the right precordial leads, the syndrome is associated with a high risk for sudden cardiac death in young and otherwise healthy adults, and less frequently in infants and children. Patients with a spontaneously appearing Brugada ECG have a high risk for sudden arrhythmic death secondary to ventricular tachycardia/fibrillation. The ECG manifestations of Brugada syndrome are often dynamic or concealed and may be unmasked or modulated by sodium channel blockers, a febrile state, vagotonic agents, {alpha}-adrenergic agonists, ß-adrenergic blockers, tricyclic or tetracyclic antidepressants, a combination of glucose and insulin, hypo- and hyperkalemia, hypercalcemia, and alcohol and cocaine toxicity. In recent years, an exponential rise in the number of reported cases and a striking proliferation of articles defining the clinical, genetic, cellular, ionic, and molecular aspects of the disease have occurred. The report of the first consensus conference, published in 2002, focused on diagnostic criteria. The present report, which emanated from the second consensus conference held in September 2003, elaborates further on the diagnostic criteria and examines risk stratification schemes and device and pharmacological approaches to therapy on the basis of the available clinical and basic science data.


Key Words: arrhythmia • death, sudden • electrocardiography • diagnosis




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B. J. Maron, J. A. Towbin, G. Thiene, C. Antzelevitch, D. Corrado, D. Arnett, A. J. Moss, C. E. Seidman, and J. B. Young
Contemporary Definitions and Classification of the Cardiomyopathies: An American Heart Association Scientific Statement From the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention
Circulation, April 11, 2006; 113(14): 1807 - 1816.
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CirculationHome page
J. M. Fish, D. R. Welchons, Y.-S. Kim, S.-H. Lee, W.-K. Ho, and C. Antzelevitch
Dimethyl Lithospermate B, an Extract of Danshen, Suppresses Arrhythmogenesis Associated With the Brugada Syndrome
Circulation, March 21, 2006; 113(11): 1393 - 1400.
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Postgrad. Med. J.Home page
M C S Hall and D M Todd
Modern management of arrhythmias
Postgrad. Med. J., February 1, 2006; 82(964): 117 - 125.
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J Clin PharmacolHome page
R. Ogawa, R. Kishi, K. Mihara, H. Takahashi, A. Takagi, N. Matsumoto, K. Masuhara, K. Nakazawa, F. Miyake, S. Kobayashi, et al.
Population Pharmacokinetic and Pharmacodynamic Analysis of a Class IC Antiarrhythmic, Pilsicainide, in Patients With Cardiac Arrhythmias
J. Clin. Pharmacol., January 1, 2006; 46(1): 59 - 68.
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CirculationHome page
J. E. Saffitz
Structural Heart Disease, SCN5A Gene Mutations, and Brugada Syndrome: A Complex Menage a Trois
Circulation, December 13, 2005; 112(24): 3672 - 3674.
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Cardiovasc ResHome page
A. O. Verkerk, R. Wilders, E. Schulze-Bahr, L. Beekman, Z. A. Bhuiyan, J. Bertrand, L. Eckardt, D. Lin, M. Borggrefe, G. Breithardt, et al.
Role of sequence variations in the human ether-a-go-go-related gene (HERG, KCNH2) in the Brugada syndrome
Cardiovasc Res, December 1, 2005; 68(3): 441 - 453.
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Clin. Chem.Home page
E. Kinoshita, E. Kinoshita-Kikuta, H. Kojima, Y. Nakano, K. Chayama, and T. Koike
Reliable and Cost-Effective Screening of Inherited Heterozygosity by Zn2+-Cyclen Polyacrylamide Gel Electrophoresis
Clin. Chem., November 1, 2005; 51(11): 2195 - 2198.
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CirculationHome page
D. Darbar, T. Yang, K. Churchwell, A. A.M. Wilde, and D. M. Roden
Unmasking of Brugada Syndrome by Lithium
Circulation, September 13, 2005; 112(11): 1527 - 1531.
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CirculationHome page
P. Brugada, R. Brugada, J. Brugada, S. G. Priori, C. Napolitano, P. Brugada, R. Brugada, J. Brugada, S. G. Priori, and C. Napolitano
Should patients with an asymptomatic Brugada electrocardiogram undergo pharmacological and electrophysiological testing?
Circulation, July 12, 2005; 112(2): 279 - 292.
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