January 1, 2006Japanese Journal of ElectrocardiologyOpen Access

Risk stratification for Brugada syndrome by signal averaged electrocardiogram under administration of pilsicainide

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Brugada syndrome (n=41). Intervention: Pilsicainide-loaded signal-averaged electrocardiogram (P-SAECG) vs. Baseline signal-averaged electrocardiogram. Primary outcome: RMS40 value during pilsicainide-loaded SAECG in patients with vs. without ventricular fibrillation induction (p=<0.05).

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Key result

Pilsicainide-loaded signal-averaged electrocardiography demonstrated a 100% negative predictive value for ventricular fibrillation induction and revealed significantly lower RMS40 values in the VF induction group (9.12 vs 15.5 μV, p<0.05).

Why the study?

Does pilsicainide-provoked signal-averaged electrocardiogram improve risk stratification for ventricular fibrillation in patients with Brugada-type ECG?

Study Design

Type

Observational (n=41)

Multicenter

Structured PICO

Does pilsicainide-provoked signal-averaged electrocardiogram improve risk stratification for ventricular fibrillation in patients with Brugada-type ECG?

Population

41 patients (mean age 56.3 years, 24.4% female) diagnosed with Brugada-type ECG without obvious underlying heart disease who underwent electrophysiological study.

Intervention

Pilsicainide 1 mg/kg intravenous over 10 minutes followed by signal-averaged electrocardiogram (SAECG) to detect late potentials (LP)

Comparator

Baseline (control) SAECG without pilsicainide

Outcome

Diagnostic accuracy (sensitivity, specificity, PPV, NPV) of late potentials for predicting ventricular fibrillation (VF) inducibility during electrophysiological study (EPS) or history of syncopesurrogate

Main Result

Absolute Event Rate: 9.12% vs 15.5%

p-value: p=<0.05

Limitations

Small sample size (41 cases)
Potential patient selection bias as the study was limited to patients who underwent both SAECG and electrophysiological study
Small sample size (n=41)
Patient selection bias for SAECG

Discussion

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Implication

Pilsicainide-provoked signal-averaged ECG has a 100% negative predictive value for VF inducibility, suggesting its utility in excluding high-risk patients with Brugada-type ECG.

Cite This Study

Mizobuchi et al. (2006) conducted an observational in Brugada syndrome (n=41). Pilsicainide-loaded signal-averaged electrocardiogram (P-SAECG) vs. Baseline signal-averaged electrocardiogram was evaluated on RMS40 value during pilsicainide-loaded SAECG in patients with vs. without ventricular fibrillation induction (p=<0.05). Pilsicainide-loaded signal-averaged electrocardiography demonstrated a 100% negative predictive value for ventricular fibrillation induction and revealed significantly lower RMS40 values in the VF induction group (9.12 vs 15.5 μV, p<0.05).

synapsesocial.com/papers/6a71b8f8ac440176ef2a4f8e https://doi.org/10.5105/jse.26.suppl4_91

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Implication

Pilsicainide-provoked signal-averaged ECG has a 100% negative predictive value for VF inducibility, suggesting its utility in excluding high-risk patients with Brugada-type ECG.

Risk stratification for Brugada syndrome by signal averaged electrocardiogram under administration of pilsicainide

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Risk stratification for Brugada syndrome by signal averaged electrocardiogram under administration of pilsicainide

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider