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Clinical and electrocardiographic predictors of positive response to the intravenous sodium channel blockers in patients suspected of the Brugada syndrome.
MedLine Citation:
PMID:  21917337     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND/OBJECTIVES: Sodium channel blockers are used to unmask the diagnostic ECG pattern of the Brugada syndrome (BrS) in case of a non-diagnostic baseline ECG. The aim of the study was to determine clinical and ECG predictors of a positive challenge test in patients suspected to the BrS. METHODS: A total of 106 consecutive patients (91 men; mean age, 35±12years) suspected of the BrS underwent the intravenous sodium channel blocker challenge test with procainamide or flecainide. RESULTS: Of the 106 patients, positive tests were detected in 20 (19%) patients. During test, a transient episode of a second-degree atrioventricular block and isolated ventricular ectopies were observed in 1 (0.9%) and 2 (1.9%) patients, respectively. A QRS prolongation ≥30% was observed in 4 (3.8%) patients. Baseline QRS duration in V1≥110ms had a sensitivity of 70% and a specificity of 80% for a positive response. An ST-segment elevation ≥0.17mV in V2 had a sensitivity of 60% and a specificity of 82% for a positive response. Of the multiple clinical and ECG variables entered into a binary logistic regression analysis, a history of syncope (P=0.001), previous cardiac arrest (P=0.001), baseline QRS duration in V1≥110ms (P=0.001), and baseline ST-segment elevation in V2≥0.17mV (P=0.012) emerged as the independent predictors of a positive response to the intravenous challenge with sodium channel blockers. CONCLUSION: The results of the sodium channel blocker challenge test can be predicted by clinical presentation and baseline ECG features.
Authors:
Shahab Shahrzad; Maryam Khoramshahi; Amir Aslani; Amir Farjam Fazelifar; Majid Haghjoo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-12
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ireland Ltd.
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