Programmed electrical stimulation for risk assessment in Brugada syndrome: time to change the guidelines?

Brugada syndrome (BrS) is a rare inheritable disorder identified by characteristic abnormalities in the anterior electrocardiographic (ECG) leads (1). The main clinical problem is sudden cardiac death (SCD). The only accepted form of SCD prevention is an implantable cardioverter defibrillator (ICD). However, the patient who undergoes ICD implantation is exposed to pain, inconvenience, and a wide variety of serious mechanical and psychological complications that might have a major negative impact on quality of life, and result in considerable cost to healthcare systems.