Flecainide challenge test: Predictors of unmasking of type 1 Brugada ECG pattern among those with non-type 1 Brugada ECG pattern.

Autor:	Prasad S; Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India., Namboodiri N; Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India. Electronic address: drbvsp@gmail.com., Thajudheen A; Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India., Singh G; Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India., Prabhu MA; Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India., Abhilash SP; Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India., Mohanan Nair KK; Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India., Rashid A; Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India., Ajit Kumar VK; Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India., Tharakan JA; Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India.
Jazyk:	angličtina
Zdroj:	Indian pacing and electrophysiology journal [Indian Pacing Electrophysiol J] 2016 Mar-Apr; Vol. 16 (2), pp. 53-58. Date of Electronic Publication: 2016 Jun 20.
DOI:	10.1016/j.ipej.2016.06.001
Abstrakt:	Background: Many subjects in community have non-type 1 Brugada pattern ECG with atypical symptoms, relevance of which is not clear. Provocative tests to unmask type 1 Brugada pattern in these patients would help in diagnosing Brugada Syndrome. However sensitivity and specificity of provocating drugs are variable. Methods: We studied 29 patients referred to our institute with clinical presentation suggestive but not diagnostic of Brugada or with non-Type 1 Brugada pattern ECG. Flecainide Challenge Test (FCT) was done in these patients (IV Flecainide test in 4 patients and Oral Flecainide in 25 patients). Resting 12-lead ECG with standard precordial leads and ECG with precordial leads placed 1 Intercostal space above were performed after flecainide administration every 5 min for first 30 min and every 30 min thereafter until ECG became normal or upto 6 h. The positivity was defined as inducible Type 1 Brugada pattern in atleast 2 right sided leads. Result: Median age was 35(range = 5-65) years. In 16 (55%) patients the Type 1 Brugada pattern was unmasked. There were no episodes of major AV block, atrial or ventricular tachyarrhythmia. Three groups were considered for analysis: Group 1(n = 9) - FCT Positive among patients with non-type 1 Brugada ECG pattern, Group 2(n = 4) - FCT Negative among the patients with non-type 1 Brugada ECG pattern, and Group 3(n = 7) - FCT Positive among patients with no spontaneous Brugada ECG pattern. Binary logistic regression analysis found that family h/o SCD was predictive of FCT positivity in Group 1 (Odd's ratio 21, 95% Confidence interval 1.04 to 698.83, p = 0.004). Conclusion: Oral flecainide is useful and safe for unmasking of Type I Brugada pattern. In our study, among the many variables studied, family history of sudden cardiac death was the only predictor of flecainide test positivity among those with non-Type 1 Brugada pattern. (Copyright © 2016 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu