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Ajmaline attenuates electrocardiogram characteristics of inferolateral early repolarization.
- Source :
-
Heart rhythm [Heart Rhythm] 2012 Feb; Vol. 9 (2), pp. 232-9. Date of Electronic Publication: 2011 Sep 10. - Publication Year :
- 2012
-
Abstract
- Background: J waves are the hallmark of both inferolateral early repolarization (ER) and Brugada syndrome. While ajmaline, a class 1a antiarrhythmic drug, accentuates the J wave in Brugada syndrome, its effect on ER is unreported.<br />Objective: To describe the effect of ajmaline on the electrocardiogram in ER.<br />Methods: We analyzed electrocardiograms before and after the administration of intravenous ajmaline (1 mg/kg) in 31 patients with ER, 21 patients with Brugada type 1 electrocardiogram (Br), and 22 controls. ER was defined as J-point elevation of ≥1 mm with QRS slurring or notching in ≥2 inferolateral leads (I, aVL, II, III, aVF, V4-V6).<br />Results: Ajmaline decreased mean J-wave amplitude in the ER group from 0.2 ± 0.15 mV at baseline to 0.08 ± 0.09 mV (P < .001). The QRS width prolonged significantly in all 3 groups, but the prolongation was significantly less in the ER group (+21 ms) than in the Br group (+36 ms; P < .001) or controls (+28 ms; P = .010). Decrease in mean inferolateral R-wave amplitude was similar in all the groups (ER group -0.14 mV; Br group -0.11 mV; controls -0.13 mV; P = ns), but mean inferolateral S-wave amplitude increased significantly less in the ER group (ER group +0.14 mV; Br group +16 mV; controls +0.20 mV; P < .001).<br />Conclusions: Ajmaline significantly decreases the J-wave amplitude in ER and prolongs the QRS width significantly less than in patients with Br. This indicates a different pathogenesis for both disorders. The altered terminal QRS vector probably is responsible for the decrease in the J-wave amplitude in ER, although a specific effect of ajmaline on J waves cannot be excluded.<br /> (Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Ajmaline therapeutic use
Anti-Arrhythmia Agents therapeutic use
Brugada Syndrome physiopathology
Case-Control Studies
Female
Humans
Male
Ajmaline pharmacology
Anti-Arrhythmia Agents pharmacology
Brugada Syndrome drug therapy
Electrocardiography drug effects
Heart Conduction System drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1556-3871
- Volume :
- 9
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Heart rhythm
- Publication Type :
- Academic Journal
- Accession number :
- 21914496
- Full Text :
- https://doi.org/10.1016/j.hrthm.2011.09.013