Abstract
Background Sustained ventricular arrhythmias (sVAs), such as polymorphic ventricular tachycardia or ventricular fibrillation, can complicate ajmaline challenge in patients with Brugada syndrome (BS). Objective To assess the incidence of life-threatening sVAs during ajmaline administration in a large series of patients with BS. In addition, clinical characteristics as well as prognosis of these patients were evaluated. Methods All consecutive patients with ajmaline-induced diagnosis of BS were eligible for this study. Results A total of 503 patients were included. Nine (1.8%) patients (44% men; mean age 26 ± 18 years) developed a life-threatening sVA during ajmaline challenge. Three patients (33%)were children, and 2 (22%) patients experienced sVAs refractory to the first external defibrillation. One patient underwent venoarterial extracorporeal membrane oxygenation to restore sinus rhythm. Age at the time of ajmaline challenge was significantly lower in patients with sVAs compared with patients without sVAs (26 ± 18 years vs 41 ± 18 years; P =.01). Moreover, patients with sVAs presented more frequently with sinus node dysfunction compared with patients with normal response to ajmaline (22.2% vs 1.4%; P =.01). After a mean follow-up time of 29 ± 8 months, none of the patients who had developed a sVA during ajmaline challenge died suddenly or developed further life-threatening ventricular arrhythmias. Conclusions sVA during ajmaline challenge is not a rare event in BS occurring in 9 (1.8%) patients. Despite its challenging acute treatment, the occurrence of ajmaline-induced sVAs in patients with BS might not identify a category at higher risk for further arrhythmic events.
| Original language | English |
|---|---|
| Pages (from-to) | 1869-1874 |
| Number of pages | 6 |
| Journal | Heart Rhythm |
| Volume | 10 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2013 |
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Keywords
- Ajmaline challenge
- Brugada syndrome
- Life-threatening ventricular arrhythmias
- Proarrhythmia
- Sudden death
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
Cite this
Life-threatening ventricular arrhythmias during ajmaline challenge in patients with Brugada syndrome : Incidence, clinical features, and prognosis. / Conte, Giulio; Sieira, Juan; Sarkozy, Andrea; De Asmundis, Carlo; Di Giovanni, Giacomo; Chierchia, Gian Battista; Ciconte, Giuseppe; Levinstein, Moises; Casado-Arroyo, Ruben; Baltogiannis, Giannis; Saenen, Johan; Saitoh, Yukio; Pappaert, Gudrun; Brugada, Pedro.
In: Heart Rhythm, Vol. 10, No. 12, 12.2013, p. 1869-1874.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Life-threatening ventricular arrhythmias during ajmaline challenge in patients with Brugada syndrome
T2 - Incidence, clinical features, and prognosis
AU - Conte, Giulio
AU - Sieira, Juan
AU - Sarkozy, Andrea
AU - De Asmundis, Carlo
AU - Di Giovanni, Giacomo
AU - Chierchia, Gian Battista
AU - Ciconte, Giuseppe
AU - Levinstein, Moises
AU - Casado-Arroyo, Ruben
AU - Baltogiannis, Giannis
AU - Saenen, Johan
AU - Saitoh, Yukio
AU - Pappaert, Gudrun
AU - Brugada, Pedro
PY - 2013/12
Y1 - 2013/12
N2 - Background Sustained ventricular arrhythmias (sVAs), such as polymorphic ventricular tachycardia or ventricular fibrillation, can complicate ajmaline challenge in patients with Brugada syndrome (BS). Objective To assess the incidence of life-threatening sVAs during ajmaline administration in a large series of patients with BS. In addition, clinical characteristics as well as prognosis of these patients were evaluated. Methods All consecutive patients with ajmaline-induced diagnosis of BS were eligible for this study. Results A total of 503 patients were included. Nine (1.8%) patients (44% men; mean age 26 ± 18 years) developed a life-threatening sVA during ajmaline challenge. Three patients (33%)were children, and 2 (22%) patients experienced sVAs refractory to the first external defibrillation. One patient underwent venoarterial extracorporeal membrane oxygenation to restore sinus rhythm. Age at the time of ajmaline challenge was significantly lower in patients with sVAs compared with patients without sVAs (26 ± 18 years vs 41 ± 18 years; P =.01). Moreover, patients with sVAs presented more frequently with sinus node dysfunction compared with patients with normal response to ajmaline (22.2% vs 1.4%; P =.01). After a mean follow-up time of 29 ± 8 months, none of the patients who had developed a sVA during ajmaline challenge died suddenly or developed further life-threatening ventricular arrhythmias. Conclusions sVA during ajmaline challenge is not a rare event in BS occurring in 9 (1.8%) patients. Despite its challenging acute treatment, the occurrence of ajmaline-induced sVAs in patients with BS might not identify a category at higher risk for further arrhythmic events.
AB - Background Sustained ventricular arrhythmias (sVAs), such as polymorphic ventricular tachycardia or ventricular fibrillation, can complicate ajmaline challenge in patients with Brugada syndrome (BS). Objective To assess the incidence of life-threatening sVAs during ajmaline administration in a large series of patients with BS. In addition, clinical characteristics as well as prognosis of these patients were evaluated. Methods All consecutive patients with ajmaline-induced diagnosis of BS were eligible for this study. Results A total of 503 patients were included. Nine (1.8%) patients (44% men; mean age 26 ± 18 years) developed a life-threatening sVA during ajmaline challenge. Three patients (33%)were children, and 2 (22%) patients experienced sVAs refractory to the first external defibrillation. One patient underwent venoarterial extracorporeal membrane oxygenation to restore sinus rhythm. Age at the time of ajmaline challenge was significantly lower in patients with sVAs compared with patients without sVAs (26 ± 18 years vs 41 ± 18 years; P =.01). Moreover, patients with sVAs presented more frequently with sinus node dysfunction compared with patients with normal response to ajmaline (22.2% vs 1.4%; P =.01). After a mean follow-up time of 29 ± 8 months, none of the patients who had developed a sVA during ajmaline challenge died suddenly or developed further life-threatening ventricular arrhythmias. Conclusions sVA during ajmaline challenge is not a rare event in BS occurring in 9 (1.8%) patients. Despite its challenging acute treatment, the occurrence of ajmaline-induced sVAs in patients with BS might not identify a category at higher risk for further arrhythmic events.
KW - Ajmaline challenge
KW - Brugada syndrome
KW - Life-threatening ventricular arrhythmias
KW - Proarrhythmia
KW - Sudden death
UR - http://www.scopus.com/inward/record.url?scp=84889877205&partnerID=8YFLogxK
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U2 - 10.1016/j.hrthm.2013.09.060
DO - 10.1016/j.hrthm.2013.09.060
M3 - Article
VL - 10
SP - 1869
EP - 1874
JO - Heart Rhythm
JF - Heart Rhythm
SN - 1547-5271
IS - 12
ER -