Clinical and electrocardiographic predictors of positive response to the intravenous sodium channel blockers in patients suspected of the Brugada syndrome.
Int J Cardiol
; 165(2): 285-90, 2013 May 10.
Article
en En
| MEDLINE
| ID: mdl-21917337
ABSTRACT
BACKGROUND/OBJECTIVES:
Sodium channel blockers are used to unmask the diagnostic ECG pattern of the Brugada syndrome (BrS) in case of a non-diagnostic baseline ECG. The aim of the study was to determine clinical and ECG predictors of a positive challenge test in patients suspected to the BrS.METHODS:
A total of 106 consecutive patients (91 men; mean age, 35 ± 12 years) suspected of the BrS underwent the intravenous sodium channel blocker challenge test with procainamide or flecainide.RESULTS:
Of the 106 patients, positive tests were detected in 20 (19%) patients. During test, a transient episode of a second-degree atrioventricular block and isolated ventricular ectopies were observed in 1 (0.9%) and 2 (1.9%) patients, respectively. A QRS prolongation ≥ 30% was observed in 4 (3.8%) patients. Baseline QRS duration in V1 ≥ 110 ms had a sensitivity of 70% and a specificity of 80% for a positive response. An ST-segment elevation ≥ 0.17 mV in V2 had a sensitivity of 60% and a specificity of 82% for a positive response. Of the multiple clinical and ECG variables entered into a binary logistic regression analysis, a history of syncope (P=0.001), previous cardiac arrest (P=0.001), baseline QRS duration in V1 ≥ 110 ms (P=0.001), and baseline ST-segment elevation in V2 ≥ 0.17 mV (P=0.012) emerged as the independent predictors of a positive response to the intravenous challenge with sodium channel blockers.CONCLUSION:
The results of the sodium channel blocker challenge test can be predicted by clinical presentation and baseline ECG features.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Bloqueadores de los Canales de Sodio
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Electrocardiografía
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Síndrome de Brugada
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Int J Cardiol
Año:
2013
Tipo del documento:
Article
País de afiliación:
Irán