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Prospective Multicentre Observational Registry of Peri-procedural Anaesthesia, Sedation and Related Medication Exposure in Patients With Brugada Syndrome (PROSP_BRUGANAE)
BRUGADA-ANAESTHESIA Registry: Prospective Multicentre Observational Registry of Peri-procedural Anaesthesia, Sedation and Related Medication Exposure in Patients With Brugada Syndrome
The goal of this observational study is to evaluate the perioperative risk of malignant ventricular arrhythmias in adult patients diagnosed with Brugada Syndrome undergoing anaesthetic procedures. Brugada Syndrome is a rare inherited cardiac condition associated with an increased risk of life-threatening arrhythmias, and perioperative management remains challenging due to limited high-quality evidence.
The main questions it aims to answer are:
- What is the incidence of malignant ventricular arrhythmias during anaesthesia and up to 30 days after the procedure?
- Are anaesthetic drugs traditionally considered "non-recommended" associated with an increased risk of perioperative arrhythmic events?
Researchers will also explore the relative contribution of anaesthetic drugs versus perioperative physiological factors (e.g., haemodynamic changes, fever, bradycardia) in triggering arrhythmias.
Participants will:
- Undergo anaesthetic procedures (general, locoregional, or sedation) as part of routine clinical care
- Have clinical data collected prospectively from electronic medical records during the perioperative period
- Be followed for 30 days after the procedure to assess outcomes, including arrhythmias, complications, ICU admission, and mortality
This is a multicentre, prospective observational registry, and no additional interventions or changes to standard clinical practice will be performed.
Studie Overzicht
Toestand
Studietype
Inschrijving (Geschat)
Contacten en locaties
Studie Locaties
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Barcelona
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Barcelona, Barcelona, Spanje, 08036
- Werving
- Hospital Clínic de Barcelona
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Contact:
- Marina Roger i Coscojuela, Medical Degree
- Telefoonnummer: +34689224084
- E-mail: mroger@clinic.cat
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Contact:
- Marc Gimenez-Milà, Medical Degree
- E-mail: magimene@clinic.cat
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Kind
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Bemonsteringsmethode
Studie Bevolking
Beschrijving
Patients should match all the inclusion criteria to be entered for data collection:
- Documented type 1 Brugada ECG pattern (spontaneous, fever-related, or induced by sodium-channel blocker challenge/other recognised provocation test) with a diagnosis considered compatible with Brugada syndrome by the treating cardiology team.
- Undergoing general anaesthesia, monitored sedation, loco-regional anaesthesia for any surgical, diagnostic, interventional, obstetric or other non-surgical procedure (including epidural analgesia for labour and sedation for endoscopy).
Patients with one or more exclusion criteria will not be included for data collection and analysis:
- No documented type 1 Brugada ECG pattern, uncertain diagnosis without sufficient supporting data.
- Refusal to participate in the study.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
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Brugada Syndrome Patients Undergoing Anaesthesia
Adult patients (≥18 years) with a confirmed diagnosis of Brugada Syndrome undergoing anaesthetic procedures (general, locoregional, or sedation) for surgical or non-surgical interventions.
This is an observational cohort with no assigned interventions.
Anaesthetic management, including the use of specific drugs (e.g., propofol, local anaesthetics, ketamine), will be performed according to routine clinical practice.
Participants will be followed during the perioperative period and up to 30 days after the procedure to assess the occurrence of malignant ventricular arrhythmias and other clinical outcomes.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Incidence of cardiac arrhytmia from the start of anaesthesia/sedation until 24 hours after the procedure
Tijdsspanne: 24 hours
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To determine the incidence of sustained ventricular tachycardia, ventricular fibrillation, arrhythmic cardiac arrest, aborted sudden cardiac death, or appropriate ICD therapy for ventricular arrhythmia from the start of anaesthesia/sedation until 24 hours after the procedure.
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24 hours
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Intraoperative anesthetic management strategies in BrS patients
Tijdsspanne: During the anesthesic procedure
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Intraoperative anesthetic management strategies in BrS patients, including use of general anaesthesia, monitored sedation, neuraxial and regional techniques across surgical, diagnostic, obstetric and non-surgical settings.
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During the anesthesic procedure
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Peri-procedural complications and relevant ECG changes
Tijdsspanne: During the anesthesic procedure
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To evaluate peri-procedural complications and relevant ECG changes, including dynamic type 1 pattern changes, bradyarrhythmias, supraventricular arrhythmias, haemodynamic instability, fever and electrolyte disturbances.
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During the anesthesic procedure
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Periprocedural complications
Tijdsspanne: Perioperative
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To assess ICU/PACU admission rates, unplanned escalation of care, need for car-dioversion/defibrillation, and peri-procedural ICD management.
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Perioperative
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30 days outcome
Tijdsspanne: 30 days after the anesthesic procedure
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To analyse 30-day outcomes, including ventricular arrhythmic events, mortality and hospital re-admission
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30 days after the anesthesic procedure
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Medewerkers en onderzoekers
Sponsor
Publicaties en nuttige links
Algemene publicaties
- Brugada P, Brugada J. Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report. J Am Coll Cardiol. 1992 Nov 15;20(6):1391-6. doi: 10.1016/0735-1097(92)90253-j.
- Espinosa A, Ripolles-Melchor J, Brugada R, Campuzano O, Sarquella-Brugada G, Abad-Motos A, Zaballos-Garcia M, Abad-Torrent A, Prieto-Gundin A, Brugada J. Brugada Syndrome: anesthetic considerations and management algorithm. Minerva Anestesiol. 2019 Feb;85(2):173-188. doi: 10.23736/S0375-9393.18.13170-1. Epub 2018 Oct 30.
- Ojaimi RE, Carteron M, Arnold S, Broux N, Corsia G, Zicarelli JP, Benhamou D. Neuraxial anesthesia for delivery in parturtients with Brugada syndrome: Local anesthetics revisited. J Gynecol Obstet Hum Reprod. 2023 May;52(5):102562. doi: 10.1016/j.jogoh.2023.102562. Epub 2023 Feb 27. No abstract available.
- Ripley A, Castro J, Gadsden J. Local anesthetics, neuraxial anesthesia, and the Brugada syndrome. J Clin Anesth. 2013 Feb;25(1):78-9. doi: 10.1016/j.jclinane.2012.06.012. Epub 2012 Dec 12. No abstract available.
- Cole JB, Sattiraju S, Bilden EF, Asinger RW, Bertog SC. Isolated tramadol overdose associated with Brugada ECG pattern. Pacing Clin Electrophysiol. 2012 Aug;35(8):e219-21. doi: 10.1111/j.1540-8159.2010.02924.x. Epub 2010 Oct 7.
- Rollin A, Maury P, Guilbeau-Frugier C, Brugada J. Transient ST elevation after ketamine intoxication: a new cause of acquired brugada ECG pattern. J Cardiovasc Electrophysiol. 2011 Jan;22(1):91-4. doi: 10.1111/j.1540-8167.2010.01766.x.
- Cuttone G, Martucci G, Napoli R, Tigano S, Arcadipane A, Pappalardo F, Sanfilippo F. Anesthesiological management of Brugada syndrome patients: A systematic review. Saudi J Anaesth. 2023 Jul-Sep;17(3):394-400. doi: 10.4103/sja.sja_205_23. Epub 2023 Jun 22.
- Duque M, Santos L, Ribeiro S, Catre D. Anesthesia and Brugada syndrome: a 12-year case series. J Clin Anesth. 2017 Feb;36:168-173. doi: 10.1016/j.jclinane.2016.09.031. Epub 2016 Dec 7.
- Flamee P, Viaene K, Tosi M, Nogueira Carvalho H, de Asmundis C, Forget P, Poelaert J. Propofol for Induction and Maintenance of Anesthesia in Patients With Brugada Syndrome: A Single-Center, 25-Year, Retrospective Cohort Analysis. Anesth Analg. 2021 Jun 1;132(6):1645-1653. doi: 10.1213/ANE.0000000000005540.
- Flamee P, Varnavas V, Dewals W, Carvalho H, Cools W, Bhutia JT, Beckers S, Umbrain V, Verborgh C, Forget P, Chierchia GB, Brugada P, Poelaert J, de Asmundis C. Electrocardiographic Effects of Propofol versus Etomidate in Patients with Brugada Syndrome. Anesthesiology. 2020 Mar;132(3):440-451. doi: 10.1097/ALN.0000000000003030.
- Postema PG, Wolpert C, Amin AS, Probst V, Borggrefe M, Roden DM, Priori SG, Tan HL, Hiraoka M, Brugada J, Wilde AA. Drugs and Brugada syndrome patients: review of the literature, recommendations, and an up-to-date website (www.brugadadrugs.org). Heart Rhythm. 2009 Sep;6(9):1335-41. doi: 10.1016/j.hrthm.2009.07.002. Epub 2009 Jul 8.
- Borrell-Vega J, Fernandez Font JD, Linares M, Martinez-Palli G, Isabel-Roquero A, Mont L, Brugada J, Arbelo E, Gimenez-Mila M. Eighteen-year analysis of anaesthetic management in Brugada syndrome: The BRUGANAES study. Eur J Anaesthesiol. 2025 May 1;42(5):458-467. doi: 10.1097/EJA.0000000000002146. Epub 2025 Feb 12.
- Brugada J, Campuzano O, Arbelo E, Sarquella-Brugada G, Brugada R. Present Status of Brugada Syndrome: JACC State-of-the-Art Review. J Am Coll Cardiol. 2018 Aug 28;72(9):1046-1059. doi: 10.1016/j.jacc.2018.06.037.
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Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- HCB/2026/0565
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