Abstract | BACKGROUND: In patients with Brugada syndrome, class I antiarrhythmic drugs can trigger ventricular arrhythmias (VA). The incidence and initial characteristics of VA that developed after pilsicainide was examined in 28 patients with Brugada-type electrocardiographic (ECG) abnormalities and with a positive response in the pilsicainide test. The clinical outcome was also compared between patients with and without pilsicainide-induced VA. METHODS AND RESULTS: In all patients, pilsicainide increased ST segment elevation and accentuated type 1 ECG changes. Ventricular tachycardia (VT) developed in 3 patients and premature ventricular complexes ( PVC) in 2 other patients. These 5 patients (group I) had higher ST segment elevation in lead V2 on the ECG at baseline and after pilsicainide and showed a longer QTc interval after pilsicainide than the other 23 patients (group II). However, there was no difference between the 2 groups regarding incidence of prior cardiac events, results of signal-averaged ECG, HV interval, inducibility of ventricular fibrillation by programmed electrical stimulation, or QRS duration. In 1 patient, PVC originated from 3 sites, 2 of which triggered polymorphic VT. The right ventricular (RV) outflow tract was the origin of 2 types of PVC, and other RV sites of 5 other types. During a 45 +/- 37 months follow-up, polymorphic VT recurred in 2 patients in group II. CONCLUSIONS:
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Authors | Masaomi Chinushi, Satoru Komura, Daisuke Izumi, Hiroshi Furushima, Yasutaka Tanabe, Takashi Washizuka, Yoshifusa Aizawa |
Journal | Pacing and clinical electrophysiology : PACE
(Pacing Clin Electrophysiol)
Vol. 30
Issue 5
Pg. 662-71
(May 2007)
ISSN: 0147-8389 [Print] United States |
PMID | 17461877
(Publication Type: Journal Article)
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Chemical References |
- Sodium Channel Blockers
- Lidocaine
- pilsicainide
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Topics |
- Adult
- Aged
- Arrhythmias, Cardiac
(chemically induced, physiopathology)
- Brugada Syndrome
(diagnosis, physiopathology)
- Electrocardiography
- Electrophysiologic Techniques, Cardiac
- Female
- Humans
- Incidence
- Lidocaine
(adverse effects, analogs & derivatives)
- Male
- Middle Aged
- Sodium Channel Blockers
(adverse effects)
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