A 37-year-old male patient, Wang, a native of Henan, had sudden onset of syncope, convulsions, loss of consciousness and urinary and fecal incontinence 7 times without any cause since March 20 this year. The local hospital diagnosed him with “myocarditis” and he was hospitalized for more than 10 days. In the past 3 months, he went to many local and Beijing hospitals and had several tests such as ECG, echocardiogram, EEG, dynamic ECG and hematology, but no abnormalities were found. The director of the cardiovascular medicine department of the hospital learned that her mother had also had similar symptoms, and after analyzing the patient’s onset and previous test results, he considered that it was likely to be a cardiogenic syncope caused by a rare heart disease called Brugada syndrome. To further confirm the diagnosis, Director Wang applied remote telephone-controlled ECG monitoring technology to the patient. At 4 a.m. on July 7, more than 20 days after this monitoring, Wang suddenly became ill during sleep – loss of consciousness, twitching of limbs, incontinence – and his family immediately collected an ECG and sent it to the remote ECG monitoring center of the First Affiliated Hospital of PLA General Hospital via the monitoring cell phone, which instantly showed the “garbled” ECG, suggesting “On July 15, Director Wang personally performed the implantation of a buried automatic cardiac defibrillator pacemaker (ICD) for the patient. After one hour of careful operation, the ICD was implanted smoothly, and ventricular stimulation was given again to induce ventricular fibrillation while the patient was sleeping, and the ICD was successfully defibrillated automatically, marking the successful implantation. Professor Wang Yu, director of the Department of Cardiology at the First Affiliated Hospital of the PLA General Hospital, said that sudden cardiac death refers to the rapid death of a patient due to sudden onset of severe arrhythmias such as ventricular fibrillation or ventricular tachycardia when the condition is basically stable. According to statistics, there are more than 540,000 sudden cardiac deaths in China every year, and an average of 1,500 sudden cardiac deaths occur every day. Among the many causes of sudden cardiac death, Brugada syndrome is one of the most important causes that cannot be ignored, especially in young men. Brugada syndrome is a familial primary heart disease caused by a genetic abnormality with a genetic predisposition. In 1986, the Brugada brothers, Spanish physicians, observed a Polish 3-year-old boy with recurrent episodes of syncope and sudden death, who was successfully resuscitated several times by his father. His father successfully resuscitated the boy, who had no organic heart disease on all tests. In 1992, the Brugada brothers were the first to report eight cases with similar clinical features, which attracted widespread attention and in 1996 the disease was named Brugada syndrome after the three brothers. Brugada syndrome is more prevalent among young and middle-aged people in Southeast Asian countries, and the sudden death rate is as high as 40% in young men aged 30-40 years old, so it is also known as “Southeast Asian sudden night death syndrome”. Although Brugada syndrome is a congenital disorder, it is difficult to detect by conventional tests such as electrocardiogram, echocardiography and exercise test, and there are no organic changes in the cardiac structure of the patient. For a long period of time, due to the limitations of medical conditions, people did not recognize this mysterious wave, and it was very easy to misdiagnose and miss the diagnosis, especially when the heart looked very healthy, without any organic problems, and the young people in the vigorous stage of life died inexplicably. Before the cause of the disease is unknown, such deaths are seen as a spell, the Philippines Tagalog people will be this disease called the mysterious “Bon Roll Gout”, which means “nightmare”; in Thailand, people call it “Lai Tai In Thailand, it is called “Lai Tai” and is believed to be the ghost of a widow who takes the life of a young man during the night. Telephonic ECG monitoring: unveiling the mystery of Brugada syndrome With the development of modern medicine, remote ECG monitoring technology began to be applied in the medical field, and remote ECG monitoring emerged, thus unveiling the mysterious electric waves of Brugada syndrome. Remote ECG monitoring is a combination of advanced wireless communication technology and conventional medical diagnosis and treatment technology. The monitor is the same size as a cell phone, easy to carry, and is not restricted by time or geography to monitor and capture the rhythm changes of the patient at the moment of abnormal symptoms at any time. Patients can go home and work normally after wearing it without the onset of the disease. The instantaneous abnormal waves are captured and transmitted to the remote ECG monitoring center through the cell phone at the onset of the disease to help doctors make an accurate diagnosis of the condition. Director Wang reminded that if a patient frequently has recurrent syncope and diseases such as epilepsy are ruled out, and no organic abnormalities are found in the routine electrophysiological examination, Brugada syndrome should be considered and the diagnosis should be confirmed using remote ECG testing. Automatic cardioverter-defibrillator: the “doctor” who wears it on the body According to media reports, when the Wenchuan earthquake occurred on May 12 last year, a patient in West China Hospital suddenly suffered a cardiac arrest, but eventually unharmed, he told the reporter during the interview the reason: more than a month ago he went to the hospital, the doctor found that he suffered from a rare heart disease –Brugada syndrome, to prevent sudden death, the doctor implanted an automatic cardioverter-defibrillator. The patient’s fear-induced cardiac arrest during the earthquake was immediately detected by the defibrillator and automatically treated with electrical defibrillation, resulting in a rapid recovery of the heart rhythm and avoiding sudden death. ”There is no effective drug treatment for Brugada syndrome, and the only effective way to prevent sudden death is to implant an automatic cardioverter-defibrillator in patients,” said Wang. The device responds quickly and effectively to life-threatening malignant arrhythmias and automatically restores the arrhythmia to normal according to the physician’s pre-determined treatment plan. The implantable automatic cardioverter-defibrillator was developed by American physician Dr. Mirowski in the 1970s and introduced in the 1980s, and is known as the “emergency room” in the chest and the “doctor” on the body. The automatic cardioverter-defibrillator continuously monitors the heart’s rhythm, noting any fast, slow or irregular heartbeat. When an arrhythmia is detected, it generates light electrical impulses that are then gradually intensified as needed through a physician’s predetermined treatment plan, providing three types of therapy: anti-tachycardia pacing, shock resuscitation and shock defibrillation. The automatic cardioverter-defibrillator recalls the number and type of treatments the patient has received, the efficacy of each treatment in aborting the arrhythmia, the state of the heart at the time of the most recent episode, the battery status, and the status of the parameter settings. Because Brugada syndrome is difficult to detect in the absence of an attack, and the success rate of resuscitation is very low when the heart is “scrambled” and a malignant arrhythmia or cardiac arrest occurs, prophylactic implantation of automatic cardioverter-defibrillators in patients with a confirmed diagnosis of Brugada syndrome or in patients at high risk of cardiac arrest is the most effective way to treat Brugada syndrome. Defibrillators are currently one of the most advanced methods in the world to treat malignant arrhythmias and prevent sudden cardiac death.