Diagnosis of Brugada Syndrome With a Sodium-Channel-Blocker Test: Who Should Be Tested? Who Should Not?

Sami Viskin*, Ehud Chorin, Raphael Rosso, Ahmad S. Amin, Arthur A. Wilde

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Intravenous infusion of sodium-channel blockers (SCB) with either ajmaline, flecainide, procainamide, or pilsicainide to unmask the ECG of Brugada syndrome is the drug challenge most commonly used for diagnostic purposes when investigating cases possibly related to inherited arrhythmia syndromes. For a patient undergoing an SCB challenge, the impact of a positive result goes well beyond its diagnostic implications. It is, therefore, appropriate to question who should undergo a SCB test to diagnose or exclude Brugada syndrome and, perhaps more importantly, who should not. We present a critical review of the benefits and drawbacks of the SCB challenge when performed in cardiac arrest survivors, patients presenting with syncope, family members of probands with confirmed Brugada syndrome, and asymptomatic patients with suspicious ECG.

Original languageEnglish
Pages (from-to)642-650
Number of pages9
JournalCirculation
Volume150
Issue number8
DOIs
StatePublished - 20 Aug 2024

Keywords

  • Brugada syndrome
  • ajmaline
  • flecainide
  • procainamide
  • sodium channel blockers
  • ventricular fibrillation

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