SYNCOPE

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SYNCOPE

• Evaluation Treatment

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FACULTY DISCLOSURES

• Medtronic
• Guidant
• St. Jude Medical
• Pfizer

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35-year old man

• A 35-year old man presents with sudden syncope.
  He has no prior cardiac history. His physical
  exam is unremarkable. An echo is normal. A
  head-up test does not reproduced the pts clinical
  symptoms. The ECG shown is obtained. At this
  point you would advise
• No specific therapy
• Empiric B-blocker
• EP Study with ICD implantation if positive
• ICD implantation

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35-year old man

• ST elevation V1 and V2, RBBB
• ECG changes are variable and dynamic (can be
  provoked by sodium channel blocking agents
  procainamide)
• MgtF
• 3rd and 4th decades
• Worldwide, but common in SE Asia

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• Right Bundle Branch Block, Persistent ST Segment
  Elevation and Sudden Cardiac
• Death A Distinct Clinical and
  Electrocardiographic Syndrome
• A Multicenter Report
• Pedro Brugada, MD, Josep Brugada, MD
• Aalst, Belgium and Barcelona Spain
• (J Am Coll Cardiol 1992201391-6)

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• Brugada syndrome and Brugada sign Clinical
  spectrum with a guide for the clinician
• (Am Heart J 200345768-78)

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