Drug Use in Brugada Syndrome: Safe or Avoid?

Background: Worldwide, Brugada syndrome (BrS) has been recognized as an important cause of sudden cardiac death at a relatively young age. BrS is diagnosed in the presence of specific electrocardiographic abnormalities (the type-1 BrS-ECG) combined with an absence of gross structural abnormalities and several other criteria. Further, BrS often shows familial aggregation. The presence of this BrS-ECG in particular has been linked to an increased risk for ventricular tachyarrhythmias, cardiac arrest and sudden death in BrS-patients. Importantly, many drugs have been reported to induce the type-1 ECG and/or (fatal) arrhythmias in BrS-patients. Therefore, it is necessary to advice patients with BrS not to use these drugs, or only in controlled conditions. Methods and Results: A review of the literature has been performed and the available evidence has been judged by a panel of renowned international experts on BrS. The drugs and the recommendations from the expert panel have been published on the website www.brugadadrugs.org. This website is kept up-to-date and includes links to the literature, background information on the listed drugs, and letters in many different languages for patients to give to their health care professionals. Over 35,000 visitors from 144 countries have already used the website, which indicates its value. Conclusions: The website www.brugadadrugs.org has been developed to ensure world-wide and up-to-date availability of information on safe drug use in BrS.