Prevalence and prognosis of patients with lone and paroxysmal atrial tachyarrhythmias showing Brugada-type electrocardiograms after class IC antiarrhythmic drug administration but no risk-stratifying factors
Background: Class IC antiarrhythmic drugs, used to prevent paroxysmal atrial tachyarrhythmias (ATs), are well known to effectively unmask the electrocardiogram (ECG) pattern of Brugada syndrome. We used these drugs to investigate the prevalence and prognosis of patients with lone and paroxysmal ATs...
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| Language: | English |
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Wiley
2013-04-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1880427613000069 |
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| author | Atsuko Abe, MD Tadashi Fujino, MD Shunji Fukunaga, MD Hitomi Yuzawa, MD Hideyuki Sato, MD Takeya Suzuki, MD Kenzaburo Kobayashi, MD Yoshifumi Okano, MD Kentaro Nakamura, MD Satoru Yusu, MD Hideaki Yoshino, MD Takashi Ashihara, MD Kazuo Nakazawa, MD Takanori Ikeda, MD |
| author_facet | Atsuko Abe, MD Tadashi Fujino, MD Shunji Fukunaga, MD Hitomi Yuzawa, MD Hideyuki Sato, MD Takeya Suzuki, MD Kenzaburo Kobayashi, MD Yoshifumi Okano, MD Kentaro Nakamura, MD Satoru Yusu, MD Hideaki Yoshino, MD Takashi Ashihara, MD Kazuo Nakazawa, MD Takanori Ikeda, MD |
| author_sort | Atsuko Abe, MD |
| collection | DOAJ |
| description | Background: Class IC antiarrhythmic drugs, used to prevent paroxysmal atrial tachyarrhythmias (ATs), are well known to effectively unmask the electrocardiogram (ECG) pattern of Brugada syndrome. We used these drugs to investigate the prevalence and prognosis of patients with lone and paroxysmal ATs and Brugada-type ECGs.
Methods and results: We enrolled 702 consecutive patients who were given class IC antiarrhythmic drugs (pilsicainide or propafenone) to inhibit paroxysmal ATs. We analyzed 12-lead ECGs before and after drug administration using a computerized ECG system. A Brugada-type ECG was defined as a coved pattern of ST segment elevation (>0.2 mV) in leads V1−V2. No patients had risk-stratifying factors of the syndrome. Forty-four patients (6.3%) had significant ST-segment elevation in leads V1−V2 after drug administration. Among these patients, a coved ECG pattern was observed in 10 (1.4%). The use of pilsicainide (n=9) was significantly (P=0.02) greater than that of propafenone (n=1). During the follow-up period of 85±19 months, none of the 10 patients had ventricular tachyarrhythmias.
Conclusions: Manifestation of Brugada-type ECGs by class IC antiarrhythmic drugs is neither rare nor serious in patients with lone and paroxysmal ATs but without risk-stratifying factors for the syndrome. |
| first_indexed | 2024-12-13T10:00:57Z |
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| id | doaj.art-37f5d0e508b54a18943849b3b3e9c7b0 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 |
| language | English |
| last_indexed | 2024-12-13T10:00:57Z |
| publishDate | 2013-04-01 |
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| series | Journal of Arrhythmia |
| spelling | doaj.art-37f5d0e508b54a18943849b3b3e9c7b02022-12-21T23:51:40ZengWileyJournal of Arrhythmia1880-42762013-04-0129213814210.1016/j.joa.2012.12.011Prevalence and prognosis of patients with lone and paroxysmal atrial tachyarrhythmias showing Brugada-type electrocardiograms after class IC antiarrhythmic drug administration but no risk-stratifying factorsAtsuko Abe, MD0Tadashi Fujino, MD1Shunji Fukunaga, MD2Hitomi Yuzawa, MD3Hideyuki Sato, MD4Takeya Suzuki, MD5Kenzaburo Kobayashi, MD6Yoshifumi Okano, MD7Kentaro Nakamura, MD8Satoru Yusu, MD9Hideaki Yoshino, MD10Takashi Ashihara, MD11Kazuo Nakazawa, MD12Takanori Ikeda, MD13Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, JapanDepartment of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, JapanDepartment of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, JapanDepartment of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, JapanDepartment of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, JapanDepartment of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, JapanDepartment of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, JapanDepartment of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, JapanSecond Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, JapanSecond Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, JapanSecond Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, JapanDepartment of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, JapanResearch Institute, National Cerebral and Cardiovascular Center, Osaka, JapanDepartment of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, JapanBackground: Class IC antiarrhythmic drugs, used to prevent paroxysmal atrial tachyarrhythmias (ATs), are well known to effectively unmask the electrocardiogram (ECG) pattern of Brugada syndrome. We used these drugs to investigate the prevalence and prognosis of patients with lone and paroxysmal ATs and Brugada-type ECGs. Methods and results: We enrolled 702 consecutive patients who were given class IC antiarrhythmic drugs (pilsicainide or propafenone) to inhibit paroxysmal ATs. We analyzed 12-lead ECGs before and after drug administration using a computerized ECG system. A Brugada-type ECG was defined as a coved pattern of ST segment elevation (>0.2 mV) in leads V1−V2. No patients had risk-stratifying factors of the syndrome. Forty-four patients (6.3%) had significant ST-segment elevation in leads V1−V2 after drug administration. Among these patients, a coved ECG pattern was observed in 10 (1.4%). The use of pilsicainide (n=9) was significantly (P=0.02) greater than that of propafenone (n=1). During the follow-up period of 85±19 months, none of the 10 patients had ventricular tachyarrhythmias. Conclusions: Manifestation of Brugada-type ECGs by class IC antiarrhythmic drugs is neither rare nor serious in patients with lone and paroxysmal ATs but without risk-stratifying factors for the syndrome.http://www.sciencedirect.com/science/article/pii/S1880427613000069Brugada syndromeParoxysmal atrial tachyarrhythmiasClass IC antiarrhythmic drugsSudden cardiac deathRisk stratification |
| spellingShingle | Atsuko Abe, MD Tadashi Fujino, MD Shunji Fukunaga, MD Hitomi Yuzawa, MD Hideyuki Sato, MD Takeya Suzuki, MD Kenzaburo Kobayashi, MD Yoshifumi Okano, MD Kentaro Nakamura, MD Satoru Yusu, MD Hideaki Yoshino, MD Takashi Ashihara, MD Kazuo Nakazawa, MD Takanori Ikeda, MD Prevalence and prognosis of patients with lone and paroxysmal atrial tachyarrhythmias showing Brugada-type electrocardiograms after class IC antiarrhythmic drug administration but no risk-stratifying factors Journal of Arrhythmia Brugada syndrome Paroxysmal atrial tachyarrhythmias Class IC antiarrhythmic drugs Sudden cardiac death Risk stratification |
| title | Prevalence and prognosis of patients with lone and paroxysmal atrial tachyarrhythmias showing Brugada-type electrocardiograms after class IC antiarrhythmic drug administration but no risk-stratifying factors |
| title_full | Prevalence and prognosis of patients with lone and paroxysmal atrial tachyarrhythmias showing Brugada-type electrocardiograms after class IC antiarrhythmic drug administration but no risk-stratifying factors |
| title_fullStr | Prevalence and prognosis of patients with lone and paroxysmal atrial tachyarrhythmias showing Brugada-type electrocardiograms after class IC antiarrhythmic drug administration but no risk-stratifying factors |
| title_full_unstemmed | Prevalence and prognosis of patients with lone and paroxysmal atrial tachyarrhythmias showing Brugada-type electrocardiograms after class IC antiarrhythmic drug administration but no risk-stratifying factors |
| title_short | Prevalence and prognosis of patients with lone and paroxysmal atrial tachyarrhythmias showing Brugada-type electrocardiograms after class IC antiarrhythmic drug administration but no risk-stratifying factors |
| title_sort | prevalence and prognosis of patients with lone and paroxysmal atrial tachyarrhythmias showing brugada type electrocardiograms after class ic antiarrhythmic drug administration but no risk stratifying factors |
| topic | Brugada syndrome Paroxysmal atrial tachyarrhythmias Class IC antiarrhythmic drugs Sudden cardiac death Risk stratification |
| url | http://www.sciencedirect.com/science/article/pii/S1880427613000069 |
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