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首页> 外文期刊>Heart rhythm: the official journal of the Heart Rhythm Society >Procainamide infusion in the evaluation of unexplained cardiac arrest: From the Cardiac Arrest Survivors with Preserved Ejection Fraction Registry (CASPER)
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Procainamide infusion in the evaluation of unexplained cardiac arrest: From the Cardiac Arrest Survivors with Preserved Ejection Fraction Registry (CASPER)

机译：普鲁卡因胺输注评估无法解释的心脏骤停：保留射血分数的心脏骤停幸存者（CASPER）

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Background Provocative testing with sodium channel blockers is advocated for the evaluation of unexplained cardiac arrest (UCA) with the primary purpose of unmasking the typical ECG features of Brugada syndrome. The Cardiac Arrest Survivors with Preserved Ejection Fraction Registry (CASPER) systematically assesses subjects with UCA or a family history of sudden death (FHSD). Objective The purpose of this study was to determine the clinical yield of procainamide infusion in a national registry of subjects with either UCA or a FHSD. Methods Subjects with either UCA or a FHSD without evidence of a Brugada pattern at baseline underwent procainamide testing (15 mg/kg to a maximum of 1 g at 50 mg/min). A test was considered positive for Brugada pattern if there was an increase in ST elevation 1 mm or if there was 1 mm of new ST elevation in leads V1 and/or V2. Genetic testing was performed on the basis of phenotype detection. Results Procainamide testing was performed in 174 subjects (age 46.8 ± 15.4 years, 47% female). Testing provoked a Brugada pattern in 12 subjects (6.9%), 5 of whom had no ST abnormalities at baseline. No subjects with a negative procainamide challenge were subsequently diagnosed with Brugada syndrome. Genetic testing was conducted in 10 of the 12 subjects with a provoked Brugada pattern and was positive for a mutation in the SCN5A gene in 1. Conclusion Irrespective of the baseline ECG, procainamide testing provoked a Brugada pattern in a significant proportion of subjects with UCA or a FHSD, thereby facilitating a diagnosis of Brugada syndrome, and is recommended in the workup of UCA.
机译：背景提倡使用钠通道阻滞剂进行激发性试验，以评估无法解释的心脏骤停（UCA），其主要目的是揭示Brugada综合征的典型ECG特征。保留射血分数登记系统（CASPER）的心脏骤停幸存者系统地评估患有UCA或猝死家族史（FHSD）的受试者。目的这项研究的目的是确定UCA或FHSD受试者的国家注册簿中普鲁卡因胺输注的临床产量。方法对患有UCA或FHSD且在基线时无Brugada模式证据的受试者进行普鲁卡因胺测试（15 mg / kg至50 mg / min时最大1 g）。如果导联V1和/或V2的ST升高增加> 1 mm或新ST升高> 1 mm，则认为该试验对Brugada模式呈阳性。根据表型检测进行基因测试。结果对174名受试者（年龄46.8±15.4岁，女性47％）进行了普鲁卡因胺测试。测试激起了12名受试者（6.9％）的Brugada模式，其中5名基线时没有ST异常。随后没有任何普鲁卡因胺激发阴性的受试者被诊断出患有Brugada综合征。在12名激发出Brugada模式的受试者中进行了10位遗传测试，并在1位发现SCN5A基因突变为阳性。结论不论基线心电图如何，普鲁卡因酰胺测试在UCA或UCA显着的受试者中均激发出Brugada模式。 FHSD，从而有助于诊断Brugada综合征，建议在UCA检查中使用。

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