Abstract
OBJECTIVES: We administered pilsicainide chloride, a class Ic pure sodium channel blocker, to patients with Brugada syndrome (BS) and evaluated the occurrence of ventricular arrhythmia (VA) and T-wave alternans (TWA). BACKGROUND: Ventricular arrhythmia and TWA are sometimes induced by a sodium channel blocker challenge test in BS patients, but the significance of the induced VA and TWA is not known. METHODS: Pilsicainide was administered to 65 patients with BS (10 symptomatic and 55 asymptomatic patients), and the occurrence of VA, TWA, and change of electrocardiogram were evaluated. Electrophysiologic study was performed in 57 patients, and the induction of VA by programmed electrical stimulation (PES) was evaluated. RESULTS: Ventricular arrhythmia was not induced by administration of pilsicainide in 55 patients (no-VA group). Administration of pilsicainide-induced VA in 10 patients (Pil-VA group) and polymorphic ventricular tachycardia in four patients. Pilsicainide-induced VA in 60% of the symptomatic patients but in only 7% of asymptomatic patients (p <0.01). ST level, QTc, and indexes of cardiac conduction in the Pil-VA group were not different from those in the no-VA group. Ventricular fibrillation was induced by PES in 67% of the patients in the Pil-VA group and in 33% of the patients in the no-VA group. In six cases, macroscopic TWA occurred in association with pilsicainide-induced VA, but TWA occurred in only one patient without pilsicainide-induced arrhythmia. CONCLUSIONS: Administration of a sodium channel blocker results in induction of not only ST-elevation but also VA and TWA in patients with BS. (J Am Coll Cardiol 2003;42:1624-31)
| Original language | English |
|---|---|
| Pages (from-to) | 1624-1631 |
| Number of pages | 8 |
| Journal | Journal of the American College of Cardiology |
| Volume | 42 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - Nov 5 2003 |
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Ventricular Arrhythmia Induced by Sodium Channel Blocker in Patients with Brugada Syndrome. / Morita, Hiroshi; Morita, Shiho Takenaka; Nagase, Satoshi; Banba, Kimikazu; Nishii, Nobuhiro; Tani, Yoshinori; Watanabe, Atsuyuki; Nakamura, Kazufumi; Kusano, Kengo Fukushima; Emori, Tetsuro; Matsubara, Hiromi; Hina, Kazumasa; Kita, Toshimasa; Ohe, Tohru.
In: Journal of the American College of Cardiology, Vol. 42, No. 9, 05.11.2003, p. 1624-1631.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Ventricular Arrhythmia Induced by Sodium Channel Blocker in Patients with Brugada Syndrome
AU - Morita, Hiroshi
AU - Morita, Shiho Takenaka
AU - Nagase, Satoshi
AU - Banba, Kimikazu
AU - Nishii, Nobuhiro
AU - Tani, Yoshinori
AU - Watanabe, Atsuyuki
AU - Nakamura, Kazufumi
AU - Kusano, Kengo Fukushima
AU - Emori, Tetsuro
AU - Matsubara, Hiromi
AU - Hina, Kazumasa
AU - Kita, Toshimasa
AU - Ohe, Tohru
PY - 2003/11/5
Y1 - 2003/11/5
N2 - OBJECTIVES: We administered pilsicainide chloride, a class Ic pure sodium channel blocker, to patients with Brugada syndrome (BS) and evaluated the occurrence of ventricular arrhythmia (VA) and T-wave alternans (TWA). BACKGROUND: Ventricular arrhythmia and TWA are sometimes induced by a sodium channel blocker challenge test in BS patients, but the significance of the induced VA and TWA is not known. METHODS: Pilsicainide was administered to 65 patients with BS (10 symptomatic and 55 asymptomatic patients), and the occurrence of VA, TWA, and change of electrocardiogram were evaluated. Electrophysiologic study was performed in 57 patients, and the induction of VA by programmed electrical stimulation (PES) was evaluated. RESULTS: Ventricular arrhythmia was not induced by administration of pilsicainide in 55 patients (no-VA group). Administration of pilsicainide-induced VA in 10 patients (Pil-VA group) and polymorphic ventricular tachycardia in four patients. Pilsicainide-induced VA in 60% of the symptomatic patients but in only 7% of asymptomatic patients (p <0.01). ST level, QTc, and indexes of cardiac conduction in the Pil-VA group were not different from those in the no-VA group. Ventricular fibrillation was induced by PES in 67% of the patients in the Pil-VA group and in 33% of the patients in the no-VA group. In six cases, macroscopic TWA occurred in association with pilsicainide-induced VA, but TWA occurred in only one patient without pilsicainide-induced arrhythmia. CONCLUSIONS: Administration of a sodium channel blocker results in induction of not only ST-elevation but also VA and TWA in patients with BS. (J Am Coll Cardiol 2003;42:1624-31)
AB - OBJECTIVES: We administered pilsicainide chloride, a class Ic pure sodium channel blocker, to patients with Brugada syndrome (BS) and evaluated the occurrence of ventricular arrhythmia (VA) and T-wave alternans (TWA). BACKGROUND: Ventricular arrhythmia and TWA are sometimes induced by a sodium channel blocker challenge test in BS patients, but the significance of the induced VA and TWA is not known. METHODS: Pilsicainide was administered to 65 patients with BS (10 symptomatic and 55 asymptomatic patients), and the occurrence of VA, TWA, and change of electrocardiogram were evaluated. Electrophysiologic study was performed in 57 patients, and the induction of VA by programmed electrical stimulation (PES) was evaluated. RESULTS: Ventricular arrhythmia was not induced by administration of pilsicainide in 55 patients (no-VA group). Administration of pilsicainide-induced VA in 10 patients (Pil-VA group) and polymorphic ventricular tachycardia in four patients. Pilsicainide-induced VA in 60% of the symptomatic patients but in only 7% of asymptomatic patients (p <0.01). ST level, QTc, and indexes of cardiac conduction in the Pil-VA group were not different from those in the no-VA group. Ventricular fibrillation was induced by PES in 67% of the patients in the Pil-VA group and in 33% of the patients in the no-VA group. In six cases, macroscopic TWA occurred in association with pilsicainide-induced VA, but TWA occurred in only one patient without pilsicainide-induced arrhythmia. CONCLUSIONS: Administration of a sodium channel blocker results in induction of not only ST-elevation but also VA and TWA in patients with BS. (J Am Coll Cardiol 2003;42:1624-31)
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U2 - 10.1016/j.jacc.2003.06.004
DO - 10.1016/j.jacc.2003.06.004
M3 - Article
VL - 42
SP - 1624
EP - 1631
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 9
ER -