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The Importance of Class-I Antiarrhythmic Drug Test in the Evaluation of Patients with Syncope: Rebreak Unmasking Brugada Syndrome.
MedLine Citation:
PMID:  21985403     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Syncope in Brugada Syndrome. Introduction: The Brugada syndrome (BrS) can first present with syncope. Class-I antiarrhythmic drug (AAD) test is used to unmask the diagnostic coved-type ECG pattern in case it is not spontaneously present. The aim of the study was to analyze patients with BrS presenting with syncope as first manifestation and compare patients with syncope and a spontaneous coved-type ECG to patients with syncope in whom a class-I AAD test unmasked the disease. Methods and Results: Fifty-eight of 157 probands (36.9%) had syncope as first manifestation of the disease. Twenty-six patients (44.8%, group A) showed a spontaneous coved-type ECG diagnostic for BrS at first presentation. In 32 patients (55.2%, group B) without spontaneous coved-type ECG pattern at first presentation (36% normal ECGs and 19% type-II ECG pattern), a class-I AAD test unmasked the disease. Twenty-one patients of group A and 29 patients of group B underwent implantable cardioverter defibrillator (ICD) implantation. The mean follow up as 9.7 ± 55.7 month. Four patients in group A (15.4%) and 3 patients (9.3%) in group B had appropriate ICD shock delivery due to ventricular fibrillation or ventricular tachycardia (P = NS). Conclusion: One of 3 patients with BrS presents first with syncope. More than one-third of these patients have a normal ECG at investigation for syncope and the correct diagnosis would have been missed without a class-I AAD test. Patients presenting with syncope are at similar risk irrespective of the presence of a spontaneous coved-type ECG. (J Cardiovasc Electrophysiol, Vol. pp. 1-6).
Authors:
Markus Roos; Andrea Sarkozy; Jeannette Brodbeck; Stefan Henkens; Gian-Battista Chierchia; Carlo DE Asmundis; Lucio Capulzini; Stephan Andreas Müller-Burri; Yoshi Yakazi; Pedro Brugada
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-10
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Affiliation:
Heart Rhythm Management Center, Vrije Universiteit Brussel, Belgium Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK.
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