Different effect of the pure Na+ channel-blocker pilsicainide on the ST-segment response in the right precordial leads in patients with normal left ventricular function.

作者信息

Ueyama Takeshi, Shimizu Akihiko, Yamagata Toshihiko, Esato Masahiro, Ohmura Masato, Yoshiga Yasuhiro, Kanemoto Masashi, Kametani Ryousuke, Sawa Akira, Suzuki Shinsuke, Sugi Naoki, Matsuzaki Masunori

机构信息

Division of Cardiovascular Medicine, Department of Medical Bioregulation, Yamaguchi University Graduate School of Medicine, Hofu, Japan.

出版信息

Circ J. 2007 Jan;71(1):57-62. doi: 10.1253/circj.71.57.

DOI:10.1253/circj.71.57

PMID:17186979

Abstract

BACKGROUND

The response of the ST-segment in the right precordial leads to Na+ channel blockers in patients without structural heart disease and a typical Brugada-type ECG has not been fully elucidated.

METHODS AND RESULTS

A pilsicainide challenge test was performed in 161 patients and according to recently established ECG criteria and an organized computer algorithm, the ST morphology was classified and the maximum increase in the J wave amplitude (maxDeltaJ) from the standard and high right precordial leads V1-3 was examined. Before the test, subjects exhibiting type 1 ECG in the standard leads were excluded. After administering pilsicainide, type 1 ECGs in the standard leads were observed in 31 cases and a maxDeltaJ of >or=200 microV was observed in 29 cases (23 type 1, 2 type 2/3 and 4 normal ECGs). In the additional higher right precordial leads, type 1 ECGs were observed in 55 cases and a maxDeltaJ of >or=200 microV was observed in 45 cases (42 type 1 and 3 type 2/3 ECGs).

CONCLUSIONS

A maxDeltaJ>or=200 microV induced by pilsicainide, including that measured in the high right precordial leads, was associated with a change mainly to a type 1 ECG.

摘要