Risk of Spontaneous vs Induced Brugada Pattern
|Risk of Spontaneous vs Induced Brugada Pattern
It is well known that sodium channel blockers can unmask the ECG pattern in Brugada syndrome. A recent systematic review and meta-analysis evaluated the utility of drug challenge in testing for Brugada syndrome. They found that spontaneous type 1 ECG characterized by coved, down sloping ST elevation with T inversion in right precordial leads had 2.4% annual incidence of serious arrhythmic events. In contrast, those with ECG pattern induced by sodium channel blockers had only 0.65% annual incidence of serious arrhythmic events.
Reference
- Rattanawong P, Kewcharoen J, Kanitsoraphan C, Vutthikraivit W, Putthapiban P, Prasitlumkum N, Mekraksakit P, Mekritthikrai R, Chung EH. The utility of drug challenge testing in Brugada syndrome: A systematic review and meta-analysis. J Cardiovasc Electrophysiol. 2020 Sep;31(9):2474-2483. doi: 10.1111/jce.14631. Epub 2020 Jul 9. PMID: 32573844.