A pilsicainide challenge test can induce polymorphic ventricular tachycardia in patients resuscitated from idiopathic ventricular fibrillation with a strong family history of arrhythmias.
Pilsicainide challenge warrants caution in idiopathic VF survivors with family arrhythmia history; leaves open its role in risk stratification.
We performed a pilsicainide challenge test in a 38-year-old man who was resuscitated from ventricular fibrillation without apparent baseline electrocardiogram (ECG) abnormality. His father had a history of ventricular fibrillation and his brother had multiple episodes of syncope. Pilsicainide (1 mg/kg) induced short coupled ventricular premature beats followed by repetitive polymorphic ventricular tachycardia without apparent J wave and ST elevation, and excessive changes in QRS duration and QT interval. An implantable cardioverter defibrillator was implanted.
No takes yet. Share an insight, caveat, or question.
Sadanaga et al. (2006) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: