AI Article Synopsis
- - Brugada syndrome (BrS) is a genetic condition that causes specific changes in heart rhythms, increasing the risk of dangerous heart arrhythmias; it can be diagnosed through an electrocardiogram (ECG) that may require sodium channel blockers like Flecainide to reveal its characteristic patterns.
- - A study highlighted two cases where a lower dose of oral Flecainide (300 mg) effectively unmasked the BrS ECG pattern within 30 minutes, peaking at about 3.5-4.5 hours post-administration, with no serious side effects observed.
- - The results suggest that a smaller dose of Flecainide could be useful in diagnosing BrS, but awareness of potential arrhythmia
Article Abstract
Background: Brugada syndrome (BrS) is a genetic disease characterized by coved ST-segment elevation in the right precordial leads that predispose to life-threatening ventricular tachyarrhythmia. The electrocardiographic signature is dynamic and often concealed but can be unmasked by potent sodium channel blockers such as Flecainide. Some studies have evaluated the effectivity of oral Flecainide 400 mg for provocative testing, but clinical utility of lower dose Flecainide (300 mg) has never been documented.
Case Summary: These two cases illustrate the effectiveness of low dose oral Flecainide to unmask Brugada electrocardiographic pattern. In our patients, diagnostic type 1 electrocardiography started to develop 30 min after drug administration and reached maximal positivity at 3.5-4.5 h. No atrioventricular block or ventricular arrhythmia was observed during the procedures.
Discussion: A potent sodium channel blocker facilitates marked reduction of the right ventricle epicardial action potential, which creates a transmural voltage dispersion and manifests as an ST elevation in the right precordial leads. Time to positivity was comparably rapid, and time to maximal ST-elevation appeared close to peak plasma level of Flecainide (ranging from 1 to 6 h). Although asymptomatic patients have a low rate of adverse cardiac events, it is crucial to inform patients to avoid various modulators and precipitating factors that could trigger malignant arrhythmias.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897198 | PMC |
| http://dx.doi.org/10.1093/ehjcr/ytac460 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Background: This study investigated drug-drug interactions in patients with atrial fibrillation taking both a direct oral anticoagulant (DOAC) and an antiarrhythmic drug.
Methods And Results: Using data from the National Health Insurance database (2012-2018), we identified 78 805 patients with atrial fibrillation on DOACs, with 24 142 taking amiodarone, 8631 taking propafenone, 2784 taking dronedarone, 297 taking flecainide, 177 taking sotalol, and 42 772 on DOACs alone. Patients with bradycardia, heart block, heart failure, mitral stenosis, prosthetic valves, or incomplete data were excluded.
Incidence of All-Cause, Cardiovascular, and Atrial Fibrillation-Related Hospitalizations: Focus on Antiarrhythmic Drugs.
JACC Adv
August 2024
Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
Background: Atrial fibrillation (AF) is associated with an increased risk of hospital admission, but few data on reasons for hospitalization and on the role of anti-arrhythmic drugs are available.
Objectives: The purpose of this study was to investigate the incidence rate and factors associated with all-cause, cardiovascular, and AF-related hospitalizations.
Methods: Prospective ongoing ATHERO-AF (Atherosclerosis in Atrial Fibrillation) cohort study enrolling AF patients on oral anticoagulants.
Wide QRS tachycardia in a patient with atrial fibrillation: a case report and approach to diagnosis.
Eur Heart J Case Rep
August 2024
Division of Cardiovascular Diseases, Heart Rhythm Services, St. Rita's Medical Center, Lima, OH 45801, USA.
Background: Wide QRS complex (QRS) tachycardia in patients with atrial fibrillation (AF) or atrial flutter treated with antiarrhythmic drugs can occur for a variety of reasons and needs careful evaluation for appropriate management of the patient.
Case Summary: We report a case of wide QRS complex tachycardia in a patient with AF treated with Flecainide who received multiple external cardioversion attempts for a presumed diagnosis of ventricular tachycardia. Intravenous Diltiazem and an oral beta-blocker led to the resolution of wide QRS complex tachycardia.
Clinical characteristics and follow-up of complex arrhythmias associated with gene mutations in children.
Front Genet
May 2024
Department of Cardiology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China.
Objective: The aim of this study was to analyze the diagnosis, treatment, and follow-up of six cases of complex arrhythmias associated with gene mutations in children.
Method: A retrospective analysis was conducted on six children diagnosed with complex arrhythmias associated with gene mutations. The study included an analysis of the age of onset, initial symptoms, electrocardiographic characteristics, genetic results, treatment course, and follow-up outcomes.
Inhaled Oral Flecainide for Rapid Cardioversion of Atrial Fibrillation.
JACC Clin Electrophysiol
June 2024
Department of Medicine, Division of Cardiology, UMass Chan School of Medicine, Worcester, Massachusetts, USA. Electronic address:
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!