Flecainide challenge test: Predictors of unmasking of type 1 Brugada ECG pattern among those with non-type 1 Brugada ECG pattern
| Autor: | Aamir Rashid, Sreevilasam Pushpangadhan Abhilash, Krishna Kumar Mohanan Nair, Mukund A. Prabhu, Gurbhej Singh, Anees Thajudheen, Jaganmohan Tharakan, V.K. Ajit Kumar, Srinivasa Prasad, Narayanan Namboodiri |
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| Rok vydání: | 2016 |
| Předmět: |
lcsh:Diseases of the circulatory (Cardiovascular) system
congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Ventricular Tachyarrhythmias 030204 cardiovascular system & hematology Sudden cardiac death 03 medical and health sciences 0302 clinical medicine Physiology (medical) Internal medicine medicine cardiovascular diseases Family history Flecainide Brugada syndrome business.industry medicine.disease Confidence interval medicine.anatomical_structure lcsh:RC666-701 Brugada ECG Pattern Cardiology Original Article Intercostal space Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Indian Pacing and Electrophysiology Journal Indian Pacing and Electrophysiology Journal, Vol 16, Iss 2, Pp 53-58 (2016) |
| ISSN: | 0972-6292 |
| DOI: | 10.1016/j.ipej.2016.06.001 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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