As per the 2015 ESC guidelines for the management of patients with VA and the prevention of SCD [
3], the patient was provided with some advice concerning lifestyle: avoidance of a variety of drugs (a complete list can be found at
www.brugadadrugs.org), avoidance of large meals or excessive alcohol intake, and immediate treatment of any fever with appropriate medication. As a next step, patients with BrS should undergo risk stratification for eligibility for ICD therapy, which remains the primary treatment option [
1]. History of aborted SCD or documented VA undoubtedly qualifies a patient for ICD therapy as for secondary prevention of SCD [
2]. In other situations (i.e. nonvagal syncope, seizures, nocturnal agonal respiration), indication for ICD remains controversial, and this is even more so in patients lacking a spontaneous type I pattern. In asymptomatic individuals, ICD implantation may be considered upon the inducibility of VA during an electrophysiological study. In the real-world practice, however, the use of this stratification tool is debated, and hence left to the discretion of the expert centers and to the electrophysiologist’s own judgement. It is important to note that the presence of SCD in a first-degree relative does not, per se, imply an increased risk of SCD in a patient with an asymptomatic BrS.