The importance of class-I antiarrhythmic drug test in the evaluation of patients with syncope: unmasking Brugada syndrome

Autor: Markus Roos, Andrea Sarkozy, Pedro Brugada, R N Stefan Henkens, Stephan Andreas Müller-Burri, Gian-Battista Chierchia, Carlo De Asmundis, Lucio Capulzini, Jeannette Brodbeck, Yoshi Yakazi
Rok vydání: 2012
Předmět:
Adult
Male
Tachycardia
medicine.medical_specialty
medicine.medical_treatment
Kaplan-Meier Estimate
Ventricular tachycardia
Syncope
Sudden cardiac death
Electrocardiography
Physiology (medical)
Internal medicine
Humans
Medicine
Prospective Studies
Registries
cardiovascular diseases
Brugada Syndrome
Brugada syndrome
Cardiovascular diseases [NCEBP 14]
medicine.diagnostic_test
biology
business.industry
Syncope (genus)
Middle Aged
medicine.disease
biology.organism_classification
Implantable cardioverter-defibrillator
Defibrillators
Implantable
Electrophysiological Phenomena
Death
Sudden
Cardiac
Treatment Outcome
Ventricular fibrillation
Tachycardia
Ventricular
Cardiology
Female
Human medicine
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Anti-Arrhythmia Agents
Follow-Up Studies
Zdroj: Journal of Cardiovascular Electrophysiology, 23, 290-5
Journal of cardiovascular electrophysiology
Journal of Cardiovascular Electrophysiology, 23, 3, pp. 290-5
ISSN: 1045-3873
Popis: 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. 23, pp. 290-295, March 2012)
Databáze: OpenAIRE
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