This condition is named after three cardiologists, the Brugada brothers, who have described this syndrome. The syndrome is characterised by the possibility of sudden death in people who present with a particular ECG pattern.
The Brugada brothers have published a long term follow up study (Circulation 2002;105:73- 78). They studied three groups of patients with Brugada pattern ECGs, some of whom have had cardiac arrests, some of whom had presented with syncope and some who were asymptomatic. Of the symptomatic group more than 70% had a family history of sudden cardiac death. The paper states that they would not diagnose Brugada syndrome in an individual with a 'saddle-like' ECG without inducing a coved type ECG on pharmacological testing. The ECG pattern may vary from time to time, making the diagnosis difficult. It is also difficult to predict its aeromedical significance.
An applicant presenting with a history of Brugada syndrome or showing a Brugada pattern of their ECG should provide:
The possible outcomes following an AMC are:
|Diagnostic features||Certification disposal|
|Definite Brugada pattern, and syncope or family history of sudden death||Ineligible|
|Definite Brugada pattern; but no syncope, and no family history of sudden death, and asymptomatic.||Class 1: No Single Pilot Air Operations carrying passengers|
|Brugada pattern not definite||Class 1 & 2: Unrestricted|
However, every conclusion is made on a case by case consideration and may differ from this advice. An electrophysiology study may be required.