Sodium Channel Blockers Identify Risk for Sudden Death in Patients With ST-Segment Elevation and Right Bundle Branch Block but Structurally Normal Hearts
Why the study?
Do intravenous sodium channel blockers effectively unmask concealed Brugada syndrome ECG patterns, and is arrhythmic risk different between transient and persistent phenotypes?
Population
130 subjects, including 34 patients with Brugada syndrome and transient normalization of the ECG, 24…
Comparison
Intravenous sodium channel blockers: ajmaline… vs Control subjects and family members without the…
Design
Cohort
Follow-up
37+/-33 months
Authors
Discussion
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Implication
Sodium channel blocker challenge may unmask concealed Brugada; supports similar arrhythmic risk in transient versus persistent phenotypes but requires prospective validation.
Structured PICO
Do intravenous sodium channel blockers effectively unmask concealed Brugada syndrome ECG patterns, and is arrhythmic risk different between transient and persistent phenotypes?
P
Population
130 subjects, including 34 patients with Brugada syndrome and transient normalization of the ECG, 24 patients with persistent phenotypic manifestation, 19 members of 3 families (11 with SCN5A mutation, 8 without), and 53 control subjects.
I
Intervention
Intravenous sodium channel blockers: ajmaline (1 mg/kg), procainamide (10 mg/kg), or flecainide (2 mg/kg)
C
Comparator
Control subjects and family members without the SCN5A mutation (for the drug challenge); patients with persistent ECG manifestations (for follow-up)
O
Outcome
Induction of ST-segment elevation and right bundle branch block on ECG, and incidence of arrhythmia during follow-upsurrogate
Intravenous sodium channel blockers effectively unmask concealed Brugada syndrome, and patients with transient ECG manifestations have a similar risk of potentially lethal arrhythmias as those with persistent manifestations.
Cite This Study
Brugada et al. (2000) studied this question.