CLINICAL RELEVANCE OF PILSICAINIDE CHALLENGETEST FOR RISK STRATIFICATION OF SUDDEN CARDIACDEATH IN PATIENTS WITH BRUGADA TYPE ECG

摘要

In 50 patients with Brugada type ECG (42 men, 8 women; mean age 54+-13 years) including 8 individuals with a family history of sudden cardiac death (group A), 16 indivuduals with a history of syncope (group B), and 26 asymptomatic individuals (group C), pilsicainide was administered and subsequent ECG changes were observed. At baseline the degree of ST elevation was similar in each groups. After pilsicainide administration, positive ECG, defined as ST elevation over 2mm in lead V2, was obtained in 6 of 8 (75%) in group A, in 10 of 16 (62.5%) in group B, and in 12 of 26 (46.2%) in group C. EPS was performed in 26 of all individuals, VF or polymorphic VT was induced in 3 of 4 (75%) in group A, in 9 of 12 (66.7%) in group B, and in 2 of 10 (20%) in group C. When we assess results from inducibility of VF or polymorphic VT, the sensitivity was 91.6% and the specificity was 57.1%. However, when we assass results from documented VF, the sensitivity was 80% and the specificity was 48.8%. Pilsicainide challenge test is not an alternative for predictor of sudden cardiac death in patient with Brugada type ECG.