Role of Provocable Brugada ECG Pattern in The Correct Risk Stratification for Major Arrhythmic Events

Journal of Clinical Medicine

Martina Testolina¹  Giovanni Morani¹  Sergio Cannas¹  GianLuca Toffanin¹  Bortolo Martini¹  Rocco Arancio²  LucaDe Mattia³  Nicolò Martini⁴ 

[1] Cardiac Unit, Alto Vicentino Hospital, 36014 Santorso (VI), Italy;Cardiac Unit, Ospedale Umberto Primo, 96100 Siracusa, Italy;Cardiac Unit, Treviso Hospital, 32111 Treviso, Italy;Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy;

关键词: ajmaline challenge;    Brugada syndrome;    early repolarization syndrome;    arrhythmogenic right ventricular cardiomyopathy;    long QT syndrome;    hypertrophic cardiomyopathy;   

DOI  :  10.3390/jcm10051025

来源: DOAJ

【 摘 要 】

The so-called Brugada syndrome (BS), first called precordial early repolarization syndrome (PERS), is characterized by the association of a fascinating electrocardiographic pattern, namely an aspect resembling right bundle branch block with a coved and sometime upsloping ST segment elevation in the precordial leads, and major ventricular arrhythmic events that could rarely lead to sudden death. Its electrogenesis has been related to a conduction delay mostly, but not only, located on the right ventricular outflow tract (RVOT), probably due to a progressive fibrosis of the conduction system. Many tests have been proposed to identify people at risk of sudden death and, among all, ajmaline challenge, thanks to its ability to enhance latent conduction defects, became so popular, even if its role is still controversial as it is neither specific nor sensitive enough to guide further invasive investigations and managements. Interestingly, a type 1 pattern has also been induced in many other cardiac diseases or systemic diseases with a cardiac involvement, such as long QT syndrome (LQTS), arrhythmogenic right ventricular cardiomyopathy (ARVC), hypertrophic cardiomyopathy (HCM) and myotonic dystrophy, without any clear arrhythmic risk profile. Evidence-based studies clearly showed that a positive ajmaline test does not provide any additional information on the risk stratification for major ventricular arrhythmic events on asymptomatic individuals with a non-diagnostic Brugada ECG pattern.

【 授权许可】

Unknown