Flecainide challenge test for the diagnosis of Brugada syndrome

Brugada Syndrome (BS) is an inherited channelopathy associated with a high incidence of sudden cardiac death. The paper presents the discovery of new genetic variants ofSCN5Agene which might be associated with the development of a concealed form of Brugada Syndrome. The study involved a group of 59 patients (37 men) with suspected concealed form of Brugada Syndrome. Pharmacological provocation with intravenous ajmaline administration was performed. Six patients with positive test results were subjected to molecular analysis ofSCN5Agene with MSSCP method. Additionally, MSSCP genotyping was performed for samples obtained from the family members with Brugada Syndrome, despite the fact that they had negative ajmaline challenge test results. Genetic examinations of theSCN5Agene at 6 positive patients showed 6 known polymorphisms, 8 new single nucleotide point (SNP) variants located at exons, and 12 new single nucleotide point variants located at introns. Among new SNPs localized inSCN5Agene exons three SNPs affected the protein sequence.

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Ajmaline versus procainamide challenge test in the diagnosis of sudden unexplained death or Brugada syndrome

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(02)80491-0 ◽

2002 ◽

Vol 39 ◽

pp. 112-113 ◽

Cited By ~ 1

Author(s):

Gumpanart Veerakul ◽

Lertlak Chaothawee ◽

Banharn Koanantakul ◽

Koonlawee Nademanee

Keyword(s):

Brugada Syndrome ◽

Challenge Test ◽

Sudden Unexplained Death ◽

Unexplained Death

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T-wave oversensing during drug challenge test after subcutaneous implantable cardioverter-defibrillator implantation in a patient with Brugada syndrome

HeartRhythm Case Reports ◽

10.1016/j.hrcr.2016.04.010 ◽

2016 ◽

Vol 2 (5) ◽

pp. 391-394 ◽

Cited By ~ 4

Author(s):

Tsukasa Kamakura ◽

Taiki Sato ◽

Mitsuru Wada ◽

Kohei Ishibashi ◽

Takashi Noda ◽

...

Keyword(s):

Implantable Cardioverter Defibrillator ◽

Brugada Syndrome ◽

Challenge Test ◽

Cardioverter Defibrillator ◽

Implantable Cardioverter Defibrillator Implantation ◽

T Wave ◽

Drug Challenge

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J-IVFS registry data investigation. Pharmacological challenge test in patients with Brugada syndrome-Relative to clinical presentation and cardiac events-

Japanese Journal of Electrocardiology ◽

10.5105/jse.26.suppl4_14 ◽

2006 ◽

Vol 26 (Suppl4) ◽

pp. 14-19

Author(s):

Yasuhiro Yokoyama ◽

Masahiko Takagi ◽

Naohiko Aihara ◽

Kazutaka Aonuma ◽

Masayasu Hiraoka

Keyword(s):

Brugada Syndrome ◽

Clinical Presentation ◽

Challenge Test ◽

Registry Data ◽

Cardiac Events ◽

Pharmacological Challenge ◽

Data Investigation

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Abstract 636: Conduction Delay in Right Ventricle as a Marker for Identifying High-Risk Patients in Brugada Syndrome

Circulation ◽

10.1161/circ.118.suppl_18.s_590-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Atsushi Doi ◽

Masahiko Takagi ◽

Keiko Maeda ◽

Hiroaki Tatsumi ◽

Kenji Shimeno ◽

...

Keyword(s):

High Risk ◽

Risk Stratification ◽

Right Ventricle ◽

Right Ventricular ◽

Brugada Syndrome ◽

Challenge Test ◽

Conduction Delay ◽

High Risk Patients ◽

Coupling Interval ◽

Risk Patients

BACKGROUND In Brugada syndrome (BS), abnormal conduction delay in right ventricle has been reported. However, the meaning of the conduction delay for risk stratification in BS is still unclear. OBJECTIVES To evaluate the significance of conduction delay in patients with BS as a marker for risk stratification. METHODS Twenty-four patients with BS in whom pilsicainide challenge test was performed (documented VF: N = 7, syncope: N = 7, and asymptomatic: N = 10) were paced from right ventricular apex (RVA), using a basic cycle length of 500ms (8 beats) and a single extrastimulus. A 2.5-French 16-electrode catheter was positioned into the coronary sinus and the great cardiac vein to record intracardiac electrograms on the epicardial sites in right ventricular outflow tract area (RVOT) and lateral left ventricle (l-LV). We measured the conduction time from the stimulus artifact at RVA to the epicardial ventricular electrogram at RVOT or l-LV. The conduction delay between RVA and RVOT (CD-RV) or between RVA and l-LV (CD-LV) was defined as the time interval between the ventricular response at RVOT (RV-V1V2) or at l-LV (LV-V1V2) and the stimulus coupling interval (S1S2) at RVA, respectively (CD-RV; RV-V1V2 minus S1S2, and CD-LV; LV-V1V2 minus S1S2). We also measured 12-lead ECG parameters at baseline and after pilsicainide challenge test, and evaluated the differences of the ECG parameters before and after pilsicainide challenge test. RESULTS Max CD-RV was significantly larger than max CD-LV in all patients (28±9 vs 19±7 ms, p<0.05). Max CD-RV in patients with documented VF was significantly larger than that in patients without (35±10 vs 25±7 ms, p<0.05). However, there was no significant difference in max CD-RV and CD-LV between patients with induced VF and those without (30±9 and 20±5 vs 26±7 and 21±7 ms, p=NS). There was significant positive correlation between max CD-RV and the differences in QRS duration in leads V1, V2, and V6 after pilsicainide administration (r = 0.51, 0.53, and 0.48, respectively, p<0.05). CONCLUSIONS The conduction delay in right ventricle (RV) was a useful marker for identifying high-risk patients in BS. The conduction delay at RV may be related to depolarization abnormality due to sodium channel dysfunction in BS.

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