Malignant Purkinje Ectopy induced by Sodium-channel Blocker
GOURRAUD, Jean‐baptiste
ITX-lab unité de recherche de l'institut du thorax UMR1087 UMR6291 [ITX-lab]
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ITX-lab unité de recherche de l'institut du thorax UMR1087 UMR6291 [ITX-lab]
GOURRAUD, Jean‐baptiste
ITX-lab unité de recherche de l'institut du thorax UMR1087 UMR6291 [ITX-lab]
ITX-lab unité de recherche de l'institut du thorax UMR1087 UMR6291 [ITX-lab]
GANDJBAKHCH, Estelle
CHU Pitié-Salpêtrière [AP-HP]
Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [ICAN]
CHU Pitié-Salpêtrière [AP-HP]
Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [ICAN]
MARTINS, Raphaël
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Laboratoire Traitement du Signal et de l'Image [LTSI]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Laboratoire Traitement du Signal et de l'Image [LTSI]
HERMIDA, Jean Sylvain
Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517 [MP3CV]
Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517 [MP3CV]
PASQUIÉ, Jean Luc
Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] [PhyMedExp]
Centre Hospitalier Régional Universitaire [Montpellier] [CHRU Montpellier]
< Réduire
Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] [PhyMedExp]
Centre Hospitalier Régional Universitaire [Montpellier] [CHRU Montpellier]
Langue
en
Article de revue
Ce document a été publié dans
Heart Rhythm. 2022-10, vol. 19, n° 10, p. 1595-1603
Elsevier
Résumé en anglais
Background: Sodium channel blocker (SCB) infusion is used to unmask the electrocardiographic pattern of Brugada syndrome. The test may also induce premature ventricular complexes (PVCs) in individuals without Brugada ...Lire la suite >
Background: Sodium channel blocker (SCB) infusion is used to unmask the electrocardiographic pattern of Brugada syndrome. The test may also induce premature ventricular complexes (PVCs) in individuals without Brugada pattern, the clinical relevance of which is little known.Objective: The purpose of this study was to describe the prevalence of short-coupled (Sc) PVCs induced by ajmaline or flecainide in patients with suspected or documented severe ventricular arrhythmias.Methods: We reviewed the SCB tests performed in 335 patients with suspected ventricular arrhythmias and structurally normal hearts in 9 centers. ScPVCs were defined as frequent and repetitive PVCs with an R-on-T pattern on SCB tests. Repeated SCB tests were performed in 7 patients and electrophysiological mapping of ScPVCs in 9.Results: Sixteen patients (8 men; mean age 36 ± 11 years) showed ScPVCs and were included. ScPVCs appeared 229 ± 118 seconds after the initiation of infusion and displayed coupling intervals of 288 ± 28 ms. ScPVC patterns were monomorphic in 12 patients, originating from the Purkinje system in mapped patients. Repetitive PVCs were induced in 15 patients (94%) including polymorphic ventricular tachycardias in 9 (56%). SCB infusion was repeated 45 (interquartile range 0.6-46) months later and induced identical ScPVC in all. SCB test was the only mean to reveal the malignant arrhythmia in 6 patients. Catheter ablation was performed in 9 patients, resulting in arrhythmia elimination in 8 with a follow-up of 6 (interquartile range 2-9) years.Conclusion: SCB can induce ScPVC, mostly from Purkinje tissue, in a small subset of patients with idiopathic ventricular arrhythmias. Its high reproducibility suggests a distinct individual mechanism.< Réduire
Mots clés en anglais
Ajmaline
Flecainide
Idiopathic ventricular fibrillation
Premature ventricular complex
Purkinje system
Project ANR
L'Institut de Rythmologie et modélisation Cardiaque - ANR-10-IAHU-0004
Origine
Importé de halUnités de recherche