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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：普鲁卡胺输注在未解释的心脏骤停评估中：从心脏捕捞幸存者与保存的射血分数注册表（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：背景技术与钠通道阻滞剂的挑衅性试验被提倡评估未解释的心脏骤停（UCA），主要目的是取消揭露Brugada综合征的典型ECG特征。具有保存的射血分数注册表（Casper）的心脏捕捞幸存者系统地评估了UCA或突然死亡（FHSD）的家族史的受试者。目的本研究的目的是确定在与UCA或FHSD的受试者的国家登记处的普华甘酰胺输注的临床产量。方法对UCA或FHSD的主题，无需基线的巴鲁达模式的证据，经过普鲁卡那滨试验（15mg / kg，最大为50mg / min的1g）。如果ST升高且GT; 1毫米或者在引线V1和/或v2中有1毫米或者如果有＆ 1mm的新的ST升高，则为Brugada模式被认为是阳性的。基于表型检测进行遗传检测。结果在174名受试者（46.8±15.4岁，47％的女性）中进行了ProcainaMide测试。在12个受试者（6.9％）中，测试挑起了Brugada模式，其中5名，其中5个在基线上没有ST异常。随后没有受到过胰蛋白酶攻击的受试者被诊断出患有Brugada综合征。在12个受试者的10个受试者中进行了遗传检测，令人挑传的Brugada图案，在SCN5A基因中的突变是阳性的1.结论无论基线ECG如何，ProcabainaMide测试都以大量比例的uca或因此，FHSD，从而促进了Brugada综合征的诊断，并建议在UCA的后处理中。

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