Ajmaline challenge can induce life-threatening sustained ventricular tachycardia requiring defibrillation.
Ajmaline challenge warrants close monitoring for VT; leaves open incidence, predictors, and safety protocols in Brugada testing.
We report the case of a 63 year old woman who comes to an ajmaline challenged. After 8 minutes of infusion her baseline ECG showed significant QRS complex prolongation and switched over to the typical coved-type ECG. Subsequently a sustained monomorphic ventricular tachycardia was developed, followed by a sustained polymorphyc VT onset, which finally degenerated in a hemodynamically non relevant sustained monomorphic VT. Finally, a 200J defibrillation was required to terminate the arrythmia.
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Picon Heras R (2017) studied this question.
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