Key result
IV ajmaline unmasks a type 1 Brugada ECG pattern over pre-existing atypical RBBB.
Why the study?
Sodium channel blockers used in ajmaline testing for suspected Brugada syndrome can induce right bundle branch block, which may preclude characteristic electrocardiographic manifestations.
Case Report (n=1)
No
Ajmaline testing for suspected Brugada syndrome can induce right bundle branch block, which may mask the characteristic type 1 Brugada ECG pattern and complicate diagnosis.
In equivocal or suspected cases of Brugada syndrome (BrS), ajmaline testing is frequently used in the diagnostic approach. However, the administration of sodium channel blockers can not only elicit the coved ST-segment elevation characteristic of type 1 Brugada pattern but also induce right bundle branch block (RBBB), which can preclude the electrocardiographic manifestations of BrS. We describe a case report wherein RBBB posed a diagnostic challenge during the ajmaline test for suspected BrS.
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Kafes et al. (2021) conducted a case report in Suspected Brugada syndrome (n=1). Ajmaline was evaluated on Electrocardiographic changes during ajmaline challenge. Intravenous administration of ajmaline unmasked a type 1 Brugada syndrome-like ECG pattern superimposed on a pre-existing atypical right bundle branch block in a 28-year-old man.
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