January 1, 2003Pacing and Clinical Electrophysiology
Flecainide Test in Brugada Syndrome: A Reproducible but Risky Tool
Key result
The flecainide test was 100% reproducible in Brugada syndrome but induced major ventricular arrhythmias in 18% of patients, with higher risk in those with SCN5A mutations (43% vs 7%, P<0.05).
Why the study?
Is the flecainide test reproducible and safe for diagnosing Brugada syndrome?
Population
22 patients with Brugada syndrome and 25 control patients without structural heart disease.
Comparison
Flecainide test, with a second test performed… vs 25 control patients without structural heart…
Design
Cohort
Follow-up
up to 2 months
Authors
Discussion
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Member takes
Implication
Requires continuous ECG monitoring during flecainide challenge; leaves open genotype-guided protocols to reduce arrhythmia risk.
Study Design
Type
Observational (n=47)
Structured PICO
Is the flecainide test reproducible and safe for diagnosing Brugada syndrome?
P
Population
22 patients with Brugada syndrome (mean age 34 years) and 25 control patients without structural heart disease undergoing flecainide testing.
E
Exposure
Flecainide test (2 mg/kg IV bolus over 10 minutes), with a second test performed within 2 months in 20 patients.
C
Comparator
25 control patients without structural heart disease who underwent the same flecainide test protocol.
O
Outcome
Reproducibility of the diagnostic ECG pattern and occurrence of major ventricular arrhythmias.safety
Main Result
Absolute Event Rate: 18% vs 0%
While the flecainide test is highly reproducible for diagnosing Brugada syndrome, it carries a significant risk of inducing major ventricular arrhythmias, particularly in patients with SCN5A mutations, necessitating strict medical supervision.
Cite This Study
Gasparini et al. (2003) conducted an observational in Brugada syndrome (n=47). Flecainide test vs. Control patients without structural heart disease was evaluated on Major ventricular arrhythmias after flecainide infusion. The flecainide test was 100% reproducible in Brugada syndrome but induced major ventricular arrhythmias in 18% of patients, with higher risk in those with SCN5A mutations (43% vs 7%, P<0.05).