Department of Cardiology, Tel-Aviv Sourasky Medical Center and School of Medicine, Tel Aviv University, Israel (S.V., E.C., R.R.).
Amsterdam University Medical Center, The Netherlands (A.S.A., A.A.W.).
Circulation. 2024 Aug 20;150(8):642-650. doi: 10.1161/CIRCULATIONAHA.124.069138. Epub 2024 Aug 19.
Intravenous infusion of sodium-channel blockers (SCB) with either ajmaline, flecainide, procainamide, or pilsicainide to unmask the ECG of Brugada syndrome is the drug challenge most commonly used for diagnostic purposes when investigating cases possibly related to inherited arrhythmia syndromes. For a patient undergoing an SCB challenge, the impact of a positive result goes well beyond its diagnostic implications. It is, therefore, appropriate to question who should undergo a SCB test to diagnose or exclude Brugada syndrome and, perhaps more importantly, who should not. We present a critical review of the benefits and drawbacks of the SCB challenge when performed in cardiac arrest survivors, patients presenting with syncope, family members of probands with confirmed Brugada syndrome, and asymptomatic patients with suspicious ECG.
静脉输注钠通道阻滞剂（SCB），如阿马林、氟卡尼、普鲁卡因胺或吡西卡尼，以揭示 Brugada 综合征的心电图，是在调查可能与遗传性心律失常综合征相关的病例时，最常用于诊断目的的药物挑战。对于接受 SCB 挑战的患者，阳性结果的影响远远超出了其诊断意义。因此，有必要质疑谁应该接受 SCB 测试来诊断或排除 Brugada 综合征，也许更重要的是，谁不应该接受。我们对在心脏骤停幸存者、晕厥患者、已确诊 Brugada 综合征先证者的家庭成员以及可疑心电图的无症状患者中进行 SCB 挑战的益处和缺点进行了批判性评估。
