Treatment of adult patients with Brugada syndrome

ECG: electrocardiogram; ICD: implantable cardioverter-defibrillator; VT: ventricular tachycardia; NSAID: nonsteroidal anti-inflammatory drug.

* Acetaminophen preferred; NSAID may be added if needed in absence of risk factors for NSAID toxicity.

¶ Refer to UpToDate content for further information. Full list of drugs to be avoided is available at https://www.brugadadrugs.org/.

Δ High-risk features include sudden cardiac arrest, arrhythmogenic syncope, documented sustained VT, and family history of Brugada syndrome.

◊ Refer to UpToDate content for further information regarding patients who are good candidates for ICDs.

§ Quinidine oral dose is 1 to 1.5 g/day of quinidine sulfate or 600 to 900 mg/day of hydroquinidine (not available in the United States), typically divided into three to four equal daily doses. Small studies have suggested that lower doses of quinidine sulfate (300 to 600 mg/day) may be effective in some patients. Strength of quinidine products available outside the United States may be expressed as salt or quinidine base; refer to local labeling for equivalence before use.

¥ Amiodarone oral dose is 200 mg daily after an initial oral loading dose (typically 400 mg twice daily or 200 mg three times daily for one to two weeks).