| Diagnosis of unexplained cardiac arrest: role of adrenaline and procainamide infusion. | |
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MedLine Citation:
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PMID: 16203906 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cardiac arrest with preserved left ventricular function may be caused by uncommon genetic conditions. Although these may be evident on the ECG, long-term monitoring or provocative testing is often necessary to unmask latent primary electrical disease. METHODS AND RESULTS: Patients with unexplained cardiac arrest and no evident cardiac disease (normal left ventricular function, coronary arteries, and resting corrected QT) underwent pharmacological challenge with adrenaline and procainamide infusions to unmask subclinical primary electrical disease. Family members underwent noninvasive screening and directed provocative testing on the basis of findings in the proband. Eighteen patients (mean+/-SD age, 41+/-17 years; 11 female) with unexplained cardiac arrest were assessed. The final diagnosis was catecholaminergic ventricular tachycardia (CPVT) in 10 patients (56%), Brugada syndrome in 2 patients (11%), and unexplained (idiopathic ventricular fibrillation) in 6 patients (33%). Of 55 family members (mean+/-SD age, 27+/-17 years; 33 female), 9 additional affected family members were detected from 2 families, with a single Brugada syndrome patient and 8 CPVT patients. CONCLUSIONS: Provocative testing with adrenaline and procainamide infusions is useful in unmasking the etiology of apparent unexplained cardiac arrest. This approach helps to diagnose primary electrical disease, such as CPVT and Brugada syndrome, and provides the opportunity for therapeutic intervention in identified, asymptomatic family members who harbor the same disease. |
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Authors:
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Andrew D Krahn; Michael Gollob; Raymond Yee; Lorne J Gula; Allan C Skanes; Bruce D Walker; George J Klein |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2005-10-03 |
Journal Detail:
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Title: Circulation Volume: 112 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-10-11 Completed Date: 2006-03-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 2228-34 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, University of Western Ontario, London, Canada. akrahn@uwo.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Arrhythmia Agents
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diagnostic use Arrhythmias, Cardiac / complications*, diagnosis, drug therapy, physiopathology Epinephrine / diagnostic use* Exercise Test Heart Arrest / diagnosis*, drug therapy, etiology, physiopathology Humans Infusions, Intravenous Procainamide / diagnostic use* Resuscitation |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents; 51-06-9/Procainamide; 51-43-4/Epinephrine |
| Comments/Corrections | |
Comment In:
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Circulation. 2005 Oct 11;112(15):2220-1
[PMID:
16216971
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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