What is the clinical evidence from this study?

Study design: Observational. Population: Normal left ventricular function without baseline type 1 Brugada ECG (n=161). Intervention: Pilsicainide vs. Baseline. Primary outcome: Maximum increase in J wave amplitude (maxΔJ) ≥200μV including high right precordial leads.

December 25, 2006Circulation JournalOpen Access

Different Effect of the Pure Na+ Channel-Blocker Pilsicainide on the ST-Segment Response in the Right Precordial Leads in Patients With Normal Left Ventricular Function

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Key result

Pilsicainide administration induced a maximum increase in J wave amplitude ≥200μV in 28% of patients when including high right precordial leads, which was strongly associated with unmasking a type 1 Brugada ECG.

Why the study?

Does a pilsicainide challenge test induce ST-segment changes and type 1 Brugada ECG patterns in patients without structural heart disease?

Population

161 patients without structural heart disease, excluding those exhibiting type 1 ECG in the standard leads…

Design

Cohort

Authors

TUTakeshi UeyamaYamaguchi Prefecture Central Hospital ASAkihiko ShimizuKagoshima University TYToshihiko YamagataYamaguchi University

Discussion

Member takes

Implication

May support high-lead pilsicainide challenge for Brugada unmasking; leaves open effects on diagnosis and risk stratification.

Study Design

Type

Observational (n=161)

Multicenter

Structured PICO

Does a pilsicainide challenge test induce ST-segment changes and type 1 Brugada ECG patterns in patients without structural heart disease?

Population

161 patients with normal left ventricular function and no baseline type 1 Brugada ECG who underwent a pilsicainide challenge test to evaluate ST-segment responses.

Intervention

Pilsicainide challenge test

Outcome

ST morphology classification and maximum increase in the J wave amplitude (maxDeltaJ) from the standard and high right precordial leads V1-3surrogate

A pilsicainide challenge test can unmask type 1 Brugada ECG patterns, especially when utilizing high right precordial leads, in patients without structural heart disease.

Limitations

The true clinical significance of a drug-induced Brugada-type ECG is unknown as it is a surrogate for genetic diagnosis.
Lack of long-term follow-up to determine if patients with unmasked type 1 ECGs will develop cardiac events.
Genetic testing was not routinely performed to confirm Brugada syndrome mutations.

Cite This Study

Ueyama et al. (2006) conducted an observational in Normal left ventricular function without baseline type 1 Brugada ECG (n=161). Pilsicainide vs. Baseline was evaluated on Maximum increase in J wave amplitude (maxΔJ) ≥200μV including high right precordial leads. Pilsicainide administration induced a maximum increase in J wave amplitude ≥200μV in 28% of patients when including high right precordial leads, which was strongly associated with unmasking a type 1 Brugada ECG.

synapsesocial.com/papers/6aa3733522af0bded4f423fb https://doi.org/10.1253/circj.71.57

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Different Effect of the Pure Na+ Channel-Blocker Pilsicainide on the ST-Segment Response in the Right Precordial Leads in Patients With Normal Left Ventricular Function

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Different Effect of the Pure Na+ Channel-Blocker Pilsicainide on the ST-Segment Response in the Right Precordial Leads in Patients With Normal Left Ventricular Function

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider