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Brugada syndrome is definitively diagnosed when type 1 ST segment elevation is observed, with one of the following: documented VF, polymorphic VT, a family history of SCD, coved type ECGs in family members, inducibility of VT, syncope, nocturnal agonal respiration but without more precision of the origin of syncope.
We followed since 2005, in our consultation seventeen patients with type 1 Brugada pattern ECG and recurrent syncope, a detailed history and physical examination were in favor of neurocardiogenic syncope but face to this ECG pattern, further tests were performed: implantable loop recorder, electrophysiological study, tilt table testing.
Only sinus tachycardia was recoded with Implantable loop recorders, we induced VF in one patient, and positive response to tilt testing in nine patients. Sixteen patients have received Disopyramide medication, along with appropriate physical manoeuvers; we reported a significant reduction in the frequency of syncopal events.
Given these observations, benign vasovagal episodes could be encountered in patients with Brugada pattern ECG, Disopyramide is more efficient, in combination with education and reassurance.