Prognostic Significance of the Sodium Channel Blocker Test in Patients With Brugada Syndrome

Journal of the American Heart Association
Akira UeokaHiroshi Ito

Abstract

A drug provocation test using a sodium channel blocker (SCB) can unmask a type 1 ECG pattern in patients with Brugada syndrome. However, the prognostic value of the results of an SCB challenge is limited in patients with non-type 1 ECG. We investigated the associations of future risk for ventricular fibrillation with SCB-induced ECG changes and ventricular tachyarrhythmias (VTAs). We administered intravenous pilsicainide to 245 consecutive patients with Brugada syndrome (181 patients with spontaneous type 1 ECG, 64 patients with non-type 1 ECG). ECG parameters before and after the test and occurrence of drug-induced VTAs were evaluated. During a mean follow-up period of 113±57 months, fatal VTA events occurred in 31 patients (sudden death: n=3, ventricular tachycardia/ventricular fibrillation: n=28). Symptomatic patients and spontaneous type 1 ECG were associated with future fatal arrhythmic events. Univariable analysis of ECG parameters after the test showed that long PQ and QRS intervals, high ST level, and SCB-induced VTAs were associated with later VTA events during follow-up. Multivariable analysis showed that symptomatic patients, high ST level (V1) ≥0.3 mV after the test, and SCB-induced VTAs were independent predictors ...Continue Reading

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Citations

May 12, 2018·Journal of the American Heart Association·Sami ViskinRaphael Rosso
Sep 12, 2019·Panminerva Medica·Milan M MarinkovićTatjana S Potpara
Jul 21, 2020·Acta Cardiologica·Haarika KorliparaSrinivas Pentyala
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