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Brugada syndrome

Nature Reviews Disease Primers volume 11, Article number: 38 (2025) Cite this article

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Abstract

Brugada syndrome (BrS) is a cardiac channelopathy associated with an elevated risk of arrhythmias and sudden cardiac death compared with the general population. Since its initial description in 1992 by Pedro and Josep Brugada, there has been tremendous progress in our understanding and management of BrS. The condition is characterized by ‘coved’ ST segment elevations in the anterior precordial electrocardiogram leads, which occasionally requires additional pharmacological provocation for diagnosis. Substantial geographical variation in the prevalence, genetic characteristics and clinical behaviour of BrS exists. Improvements in the understanding of the genetic and molecular mechanisms of the condition have been made over the past 30 years, opening avenues for the discovery of diagnostic and management opportunities. In this Primer, we discuss the evolving epidemiology of BrS, the emerging genetic understanding of the condition, as well as its diagnosis and management. We summarize the major societal guideline recommendations pertaining to BrS and highlight the potential for technological advancements, such as digital health and machine learning, to improve patient care.

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Fig. 1: Characteristic ECG patterns of the Brugada pattern.
Fig. 2: Pathophysiology of Brugada syndrome.
Fig. 3: Algorithm for the treatment of Brugada syndrome.

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Acknowledgements

The authors thank S. J. Asirvatham for his insightful suggestions and comments on this article.

Author information

Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Bharat Narasimhan

  2. Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA

    Jonathan Na

  3. Arrhythmology Department, IRCCS Policlinico San Donato, Milan, Italy

    Michelle M. Monasky

  4. Cardiology, Cardiac Genetics Clinical Unit, Hospital Universitari Josep Trueta, Hospital Santa Caterina, Girona, Spain

    Ramon Brugada

  5. Cardiovascular Genetics Center and Clinical Diagnostic Laboratory, Institut d’Investigació Biomèdica Girona-IdIBGi, CIBERCV, Salt, Spain

    Ramon Brugada

  6. Division of Cardiology, Department of Medicine II, Kansai Medical University, Osaka, Japan

    Yoko Miyasaka

  7. Cardiovascular Institute, Hospital Clínic, Barcelona, Spain

    Josep Brugada

  8. Paediatric Arrhythmia Unit, Hospital Sant Joan de Déu, Barcelona, Spain

    Josep Brugada

  9. Department of Medicine, University of Barcelona, Barcelona, Spain

    Josep Brugada

  10. Cardiovascular Division, Free University of Brussels (UZ Brussel) VUB, Brussels, Belgium

    Pedro Brugada

  11. Medical Centre Prof. Brugada, Aalst, Belgium

    Pedro Brugada

  12. Arrhythmia Unit, Helicopteros Sanitarios Hospital, Marbella, Spain

    Pedro Brugada

  13. Section of Cardiology, Baylor College of Medicine, Houston, TX, USA

    Chayakrit Krittanawong

  14. Human X, Delaware, DE, USA

    Chayakrit Krittanawong

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  1. Bharat Narasimhan
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  2. Jonathan Na
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  3. Michelle M. Monasky
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  4. Ramon Brugada
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The authors contributed equally to all aspects of the article.

Corresponding authors

Correspondence to Pedro Brugada or Chayakrit Krittanawong.

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Competing interests

C.K. is the founder of HumanX, a company that focuses on artificial intelligence in precision medicine and innovation in health care; he declares that his affiliation with HumanX is not a competing interest. The other authors declare no competing interests.

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Nature Reviews Disease Primers thanks M. Hocini, who co-reviewed with J. Duchateau; H. Morita; K. Nademanee; K. Nakamura; and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Narasimhan, B., Na, J., Monasky, M.M. et al. Brugada syndrome. Nat Rev Dis Primers 11, 38 (2025). https://doi.org/10.1038/s41572-025-00622-5

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