دورية أكاديمية
Sodium-channel blocker challenge in the familial screening of Brugada syndrome: safety and predictors of positivity
| العنوان: | Sodium-channel blocker challenge in the familial screening of Brugada syndrome: safety and predictors of positivity |
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| المؤلفون: | Therasse, Dylan, Sacher, Frédéric, Petit, Bertrand, Babuty, Dominique, Mabo, Philippe, Martins, Raphael, Jesel, Laurence, Maury, Philippe, Pasquie, Jean, Luc, Mansourati, Jacques, Dupuis, Jean, Marc, Kyndt, Florence, Thollet, Aurélie, Guyomarch, Beatrice, Barc, Julien, Schott, Jean, Jacques, Le Marec, Hervé, Redon, Richard, Probst, Vincent, Gourraud, Jean-Baptiste |
| المساهمون: | ITX - unité de recherche de l'institut du thorax (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux, CHR La réunion, CHU Trousseau Tours, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de cardiologie et maladies vasculaires Rennes = Cardiac, Thoracic, and Vascular Surgery Rennes, Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire Strasbourg (CHU Strasbourg), Les Hôpitaux Universitaires de Strasbourg (HUS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Montpellier, Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier) |
| المصدر: | ISSN: 1556-3871. |
| بيانات النشر: | HAL CCSD Elsevier |
| سنة النشر: | 2017 |
| المجموعة: | Université de Rennes 1: Publications scientifiques (HAL) |
| مصطلحات موضوعية: | Flecainide, Sodium-channel blocker challenge, Brugada syndrome, Complication, Ajmaline, [SDV.IB]Life Sciences [q-bio]/Bioengineering, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system |
| الوصف: | International audience ; Background - Sodium-channel blocker challenge (SCBC) is frequently performed to unmask Brugada syndrome. Objective - We aim to identify predictors of positivity and complications of SCBC in the setting of familial screening of Brugada syndrome. Methods - All consecutive patients from 2000 to 2014 who benefit from a sodium-channel blocker and belong to a family with at least 2 subjects affected by the syndrome were enrolled and followed prospectively. Data were reviewed by 2 physicians blinded to the clinical and genetic status. Results - Of the 672 SCBCs performed in 137 families, 337 (50%) were positive. Multivariate analysis identified ajmaline (odds ratio [OR] 2.98; 95% CI 1.65-4.91) and a significant S wave in lead DII (OR 3.11; 95% CI 2.12-4.58), DIII (OR 2.75; 95% CI 1.78-4.25), or V (OR 3.71; 95% CI 2.54-5.44) as predictors of a positive SCBC (P < .0001). Eleven patients (1.6%) presented complications (10 ventricular arrhythmias and 1 atrial flutter), but no deaths occurred. Familial history of complications (OR 41; lower quartile, upper quartile 10, 203; P < .0001), young age (P = .04), and decreased electrocardiographic conduction parameters at baseline (P = .04) were predictors of complications. QRS enlargement during SCBC was not associated with complications. During a median follow-up of 106 months (lower quartile, upper quartile 54, 143 months), 11 life-threatening arrhythmias occurred. Conclusion - SCBC in the screening of familial Brugada syndrome is safe. The risk of complication is considerably increased in the case of familial history of complicated SCBC, in young patients, and in the presence of decreased electrocardiographic conduction parameters. However, QRS enlargement during the test is not directly related to complications and should not be used to prematurely stop the test unless leading to false-negative results. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/28666944; hal-01650124; https://univ-rennes.hal.science/hal-01650124Test; https://univ-rennes.hal.science/hal-01650124/documentTest; https://univ-rennes.hal.science/hal-01650124/file/Therasse%20et%20al.%20-%20Sodium-channel%20blocker%20challenge%20in%20the%20familial%20s.pdfTest; PUBMED: 28666944 |
| DOI: | 10.1016/j.hrthm.2017.06.031 |
| الإتاحة: | https://doi.org/10.1016/j.hrthm.2017.06.031Test https://univ-rennes.hal.science/hal-01650124Test https://univ-rennes.hal.science/hal-01650124/documentTest https://univ-rennes.hal.science/hal-01650124/file/Therasse%20et%20al.%20-%20Sodium-channel%20blocker%20challenge%20in%20the%20familial%20s.pdfTest |
| حقوق: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.54E4CC97 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.hrthm.2017.06.031 |
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