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Ajmaline infusion for unmasking short-coupled Purkinje ectopy: Need for speed?
Heart Rhythm
August 2024
Department of Cardiology, UZ Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, UZ Leuven, Leuven, Belgium. Electronic address:
Diagnosis of Brugada Syndrome With a Sodium-Channel-Blocker Test: Who Should Be Tested? Who Should Not?
Circulation
August 2024
Amsterdam University Medical Center, The Netherlands (A.S.A., A.A.W.).
Intravenous infusion of sodium-channel blockers (SCB) with either ajmaline, flecainide, procainamide, or pilsicainide to unmask the ECG of Brugada syndrome is the drug challenge most commonly used for diagnostic purposes when investigating cases possibly related to inherited arrhythmia syndromes. For a patient undergoing an SCB challenge, the impact of a positive result goes well beyond its diagnostic implications. It is, therefore, appropriate to question who should undergo a SCB test to diagnose or exclude Brugada syndrome and, perhaps more importantly, who should not.
View Article and Find Full Text PDFArticle Synopsis
- The study focuses on the diagnostic process of Brugada syndrome (BrS) using ajmaline to expose the Type 1 Brugada pattern in patients, highlighting limited data on different populations.
- It analyzed 260 patients (average age 43.4, mostly males) who underwent ajmaline tests, revealing a significant number with syncope history and family backgrounds of BrS or sudden cardiac death.
- Results showed that less than half of the subjects met the current diagnostic criteria for BrS, but the overall rate of serious arrhythmia events was low over a median follow-up period of three years.
Case Report: Lacosamide unmasking -associated Brugada syndrome in a young female with epilepsy.
Front Cardiovasc Med
May 2024
Cardiovascular Center, Center of Heart Failure and Center of Genetic Heart Diseases, Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Background: Lacosamide is frequently used as a mono- or adjunctive therapy for the treatment of adults with epilepsy. Although lacosamide is known to act on both neuronal and cardiac sodium channels, potentially leading to cardiac arrhythmias, including Brugada syndrome (BrS), its adverse effects in individuals with genetic susceptibility are less understood.
Case: We report a 33-year-old female with underlying epilepsy who presented to the emergency department with a four-day history of seizure clusters, and was initially treated with lacosamide therapy.
Brugada Syndrome and Pulmonary Atresia with Intact Interventricular Septum: Fortuitous Finding or New Genetic Connection?
Genes (Basel)
May 2024
Arrhythmia, Inherited Cardiac Diseases and Sudden Death Unit, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, Esplugues de Llobregat, 08950 Barcelona, Spain.
Article Synopsis
- * Right ventricle outflow tract fibrosis has been observed in some Brugada syndrome patients, indicating structural issues in the heart.
- * A case is reported of a 4-year-old boy with pulmonary atresia showing a Brugada pattern after testing, suggesting that certain genetic variants may cause both conditions to develop similarly.
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