Key result
Pilsicainide administration significantly increased temporal QT interval variability in the right precordial leads of patients with Brugada syndrome compared to baseline (P<0.01).
Why the study?
Does pilsicainide administration increase temporal QT interval variability in patients with Brugada syndrome?
Observational (n=26)
Does pilsicainide administration increase temporal QT interval variability in patients with Brugada syndrome?
p-value: p=< 0.01
May signal proarrhythmic effects during pilsicainide challenge in Brugada syndrome; hypothesis-generating and requires outcome validation.
BACKGROUND: Temporal QT interval variability is associated with sudden cardiac death. The purpose of this study was to evaluate temporal QT interval variability in Brugada syndrome (BS). METHODS: We measured QT and RR intervals in precordial leads (V(1)-V(6)) based on 12-beat resting ECG recordings from 16 BS patients (B group) with spontaneous ST elevation in right precordial leads (V(1)-V(2)) and from 10 patients with normal hearts (C group). We measured the response in B group before and after administration of pilsicainide (1 mg/kg). The standard deviation (QT-SD, RR-SD) of the time domain and total frequency power (QT-TP, RR-TP) were calculated for all precordial leads, and the latter was to analyze the frequency domain. RESULTS: The right precordial leads in BS exhibited an additional and prominent ST elevation (coved-type) after pilsicainide administration. Both QT-SD and QT-TP values were significantly more increased in B, than in C (5.1 +/- 1.2 vs 3.6 +/- 0.2 and 23.4 +/- 2.9 vs 12.3 +/- 1.7 msec(2), P < 0.01, respectively) and after pilsicainide administration in B. (5.1 +/- 0.4 vs 3.9 +/- 0.3, 25.8 +/- 3.4 vs 16.3 +/- 2.6 msec(2), P < 0.01, respectively) However, QT-SD and QT-TP did not significantly change in any of other leads (V(3)-V(6)) and RR-SD and RR-TP were similar for both groups, as well as after intravenous pilsicainide administration in B. CONCLUSIONS: The temporal QT interval variability was identified in BS. Moreover, sodium channel blocker induced temporal fluctuation in QT interval and it may possibly provide a substrate for ventricular arrhythmia in BS patients.
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Kanemori et al. (2008) conducted an observational in Brugada syndrome (n=26). Pilsicainide vs. Normal hearts / Baseline was evaluated on Temporal QT interval variability (QT-SD and QT-TP) in right precordial leads (p=< 0.01). Pilsicainide administration significantly increased temporal QT interval variability in the right precordial leads of patients with Brugada syndrome compared to baseline (P<0.01).
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