Positive Brugada challenge test in V1 R-V3 R as a predictor of malignant prognosis in Brugada patients.

Background: The Brugada syndrome is a heterogeneous genetic disease that predisposes to life-threatening ventricular tachyarrhythmias and sudden cardiac death (SCD). The only proven way to prolong the survival of patients with Brugada syndrome is to implant an implantable cardioverter-defibrillator (ICD). This should be implanted for high-risk patients only.
Method: The patients with type 2 or 3 Brugada ECG pattern were selected for the study. We evaluated 126 patients with Brugada type ECG patterns. Nineteen patients had positive response. Those who had positive result in right side located leads had poorer prognosis.
Conclusion: Positive flecainide challenge test in right side located pericordial leads can be used as a predictor of poor prognosis in Brugada patients. This can be evaluated in another research for its role in the implantation of ICD. Also, the oral flecainide is not sensitive enough to rule out the presence of Brugada syndrome and it should not be trusted as a screening test for suspected cases.
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