Acute ED management depends on presenting symptoms
No acute treatment
Cardiology consultation and likely admission
Consider EP consult and VF-inducing electrophysiologic study (EPS), though EPS is controversial prognosticator
Consider EP consult and VF-inducing electrophysiologic study (EPS), though EPS is controversial prognosticator
Antidysrhythmics trials have inconsistently shown clinical benefit, but potential VF-terminating and prevention meds may include quinidine, isoproterenol
See electrical storm for 3 or more episodes of sustained ventricular tachycardia, ventricular fibrilation, or ICD shocks within 24 hours
If starting or using new med, check www.brugadadrugs.org drug list
Commonly used meds to avoid include:
Procainamide
Bupivacaine
Propofol
Ketamine
Tramadol
Lithium
Except for quinidine, class I antiarrhythmic drugs, particularly sodium channel blockers such as procainamide and flecainide should be avoided
Certain antiepileptic medications
Certain tricyclic antidepressants
Certain SSRIs
Procainamide
Bupivacaine
Propofol
Ketamine
Tramadol
Lithium
Except for quinidine, class I antiarrhythmic drugs, particularly sodium channel blockers such as procainamide and flecainide should be avoided
Certain antiepileptic medications
Certain tricyclic antidepressants
Certain SSRIs
Brugada syndrome
Cardiac
Vincent's angina
ST-segment elevation myocardial infarction 
Torsades de pointes
Post-MI 
Takotsubo cardiomyopathy
Previous MI with recurrent ischemia in same area