Heart Rhythm
Volume 6, Issue 9 , Pages 1335-1341 , September 2009

Drugs and Brugada syndrome patients: Review of the literature, recommendations, and an up-to-date website (www.brugadadrugs.org)

  • Pieter G. Postema, MD

      Affiliations

    • Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    • Corresponding Author InformationAddress reprint requests and correspondence: Dr. Pieter G. Postema or Dr. Arthur A. M. Wilde, Department of Cardiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands
    • ,
  • Christian Wolpert, MD

      Affiliations

    • 1st Department of Medicine-Cardiology, University Hospital Mannheim, Mannheim, Germany
    • ,
  • Ahmad S. Amin, MD

      Affiliations

    • Heart Failure Research Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    • ,
  • Vincent Probst, MD, PhD

      Affiliations

    • L'Institut du Thorax, Service de Cardiologie du CHU de Nantes and INSERM UMR 915, Université de Nantes, Nantes, France
    • ,
  • Martin Borggrefe, MD, PhD

      Affiliations

    • 1st Department of Medicine-Cardiology, University Hospital Mannheim, Mannheim, Germany
    • ,
  • Dan M. Roden, MD

      Affiliations

    • Department of Medicine and Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee
    • ,
  • Silvia G. Priori, MD, PhD

      Affiliations

    • Molecular Cardiology, Fondazione Salvatore Maugeri, Department of Cardiology, University of Pavia, Pavia, Italy
    • ,
  • Hanno L. Tan, MD, PhD

      Affiliations

    • Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    • Heart Failure Research Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    • ,
  • Masayasu Hiraoka, MD, PhD

      Affiliations

    • Department of Cardiovascular Diseases, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
    • ,
  • Josep Brugada, MD, PhD

      Affiliations

    • Arrhythmia Section, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
    • ,
  • Arthur A.M. Wilde, MD, PhD

      Affiliations

    • Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    • Heart Failure Research Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    • Corresponding Author InformationAddress reprint requests and correspondence: Dr. Pieter G. Postema or Dr. Arthur A. M. Wilde, Department of Cardiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands

Received 26 June 2009 ,Accepted 3 July 2009.

References 

  1. Antzelevitch C, Brugada P, Borggrefe M, et al. Brugada syndrome: report of the second consensus conference. Heart Rhythm. 2005;2:429–440
  2. Wilde AA, Antzelevitch C, Borggrefe M, et al. Proposed diagnostic criteria for the Brugada syndrome: consensus report. Circulation. 2002;106:2514–2519
  3. Gehi AK, Duong TD, Metz LD, Gomes JA, Mehta D. Risk stratification of individuals with the Brugada electrocardiogram: a meta-analysis. J Cardiovasc Electrophysiol. 2006;17:577–583
  4. Paul M, Gerss J, Schulze-Bahr E, et al. Role of programmed ventricular stimulation in patients with Brugada syndrome: a meta-analysis of worldwide published data. Eur Heart J. 2007;28:2126–2133
  5. Eckardt L, Probst V, Smits JP, et al. Long-term prognosis of individuals with right precordial ST-segment-elevation Brugada syndrome. Circulation. 2005;111:257–263
  6. Amin AS, Meregalli PG, Bardai A, Wilde AA, Tan HL. Fever increases the risk for cardiac arrest in the Brugada syndrome. Ann Intern Med. 2008;149:216–218
  7. Skinner JR, Chung SK, Nel CA, et al. Brugada syndrome masquerading as febrile seizures. Pediatrics. 2007;119:e1206–e1211
  8. Belhassen B, Glick A, Viskin S. Efficacy of quinidine in high-risk patients with Brugada syndrome. Circulation. 2004;110:1731–1737
  9. Probst V, Denjoy I, Meregalli PG, et al. Clinical aspects and prognosis of Brugada syndrome in children. Circulation. 2007;115:2042–2048
  10. Mizusawa Y, Sakurada H, Nishizaki M, Hiraoka M. Effects of low-dose quinidine on ventricular tachyarrhythmias in patients with Brugada syndrome: low-dose quinidine therapy as an adjunctive treatment. J Cardiovasc Pharmacol. 2006;47:359–364
  11. Perez Riera AR, Filho CF, Uchida AH, et al. Study of the extent of the information of cardiologists from Sao Paulo city, Brazil, regarding a low-prevalence entity: Brugada syndrome. Ann Noninvasive Electrocardiol. 2008;13:352–363
  12. Viskin S, Wilde AA, Tan HL, Antzelevitch C, Shimizu W, Belhassen B. Empiric quinidine therapy for asymptomatic Brugada syndrome: time for a prospective registry. Heart Rhythm. 2009;6:401–404
  13. Marquez MF, Salica G, Hermosillo AG, et al. Ionic basis of pharmacological therapy in Brugada syndrome. J Cardiovasc Electrophysiol. 2007;18:234–240
  14. Sugao M, Fujiki A, Nishida K, et al. Repolarization dynamics in patients with idiopathic ventricular fibrillation: pharmacological therapy with bepridil and disopyramide. J Cardiovasc Pharmacol. 2005;45:545–549
  15. Ohgo T, Okamura H, Noda T, et al. Acute and chronic management in patients with Brugada syndrome associated with electrical storm of ventricular fibrillation. Heart Rhythm. 2007;4:695–700
  16. Fish JM, Welchons DR, Kim YS, Lee SH, Ho WK, Antzelevitch C. Dimethyl lithospermate B, an extract of Danshen, suppresses arrhythmogenesis associated with the Brugada syndrome. Circulation. 2006;113:1393–1400
  17. Miyazaki T, Mitamura H, Miyoshi S, Soejima K, Aizawa Y, Ogawa S. Autonomic and antiarrhythmic drug modulation of ST segment elevation in patients with Brugada syndrome. J Am Coll Cardiol. 1996;27:1061–1070
  18. Kasanuki H, Ohnishi S, Ohtuka M, et al. Idiopathic ventricular fibrillation induced with vagal activity in patients without obvious heart disease. Circulation. 1997;95:2277–2285
  19. Bertaglia E, Michieletto M, Spedicato L, Pascotto P. Right bundle branch block, intermittent ST segment elevation and inducible ventricular tachycardia in an asymptomatic patient: an unusual presentation of the Brugada syndrome?. G Ital Cardiol. 1998;28:893–898
  20. Glatter KA, Wang Q, Keating M, Chen S, Chiamvimonvat N, Scheinman MM. Effectiveness of sotalol treatment in symptomatic Brugada syndrome. Am J Cardiol. 2004;93:1320–1322
  21. Perez Riera AR, Zhang L, Uchida AH, Schapachnik E, Dubner S, Ferreira C. The management of Brugada syndrome patients. Cardiol J. 2007;14:97–106
  22. Johnson JN, Hofman N, Haglund CM, Cascino GD, Wilde AA, Ackerman MJ. Identification of a possible pathogenic link between congenital long QT syndrome and epilepsy. Neurology. 2009;72:224–231
  23. Bahls FH, Ozuna J, Ritchie DE. Interactions between calcium channel blockers and the anticonvulsants carbamazepine and phenytoin. Neurology. 1991;41:740–742
  24. Cave G, Sleigh JW. ECG features of sodium channel blockade in rodent phenytoin toxicity and effect of hypertonic saline. Vet Hum Toxicol. 2003;45:254–255
  25. Segal MM, Douglas AF. Late sodium channel openings underlying epileptiform activity are preferentially diminished by the anticonvulsant phenytoin. J Neurophysiol. 1997;77:3021–3034
  26. Brugada J, Brugada P. Further characterization of the syndrome of right bundle branch block, ST segment elevation, and sudden cardiac death. J Cardiovasc Electrophysiol. 1997;8:325–331
  27. Rolf S, Bruns HJ, Wichter T, et al. The ajmaline challenge in Brugada syndrome: diagnostic impact, safety, and recommended protocol. Eur Heart J. 2003;24:1104–1112
  28. Wolpert C, Echternach C, Veltmann C, et al. Intravenous drug challenge using flecainide and ajmaline in patients with Brugada syndrome. Heart Rhythm. 2005;2:254–260
  29. Bebarova M, O'Hara T, Geelen JL, et al. Subepicardial phase-0 block and discontinuous transmural conduction underlie right-precordial ST-segment elevation by a SCN5A loss-of-function mutation. Am J Physiol Heart Circ Physiol. 2008;295:H48–H58
  30. Krishnan SC, Josephson ME. ST segment elevation induced by class IC antiarrhythmic agents: underlying electrophysiologic mechanisms and insights into drug-induced proarrhythmia. J Cardiovasc Electrophysiol. 1998;9:1167–1172
  31. Brugada R, Brugada J, Antzelevitch C, et al. Sodium channel blockers identify risk for sudden death in patients with ST-segment elevation and right bundle branch block but structurally normal hearts. Circulation. 2000;101:510–515
  32. Gasparini M, Priori SG, Mantica M, et al. Flecainide test in Brugada syndrome: a reproducible but risky tool. Pacing Clin Electrophysiol. 2003;26:338–341
  33. Meregalli PG, Ruijter JM, Hofman N, Bezzina CR, Wilde AA, Tan HL. Diagnostic value of flecainide testing in unmasking SCN5A-related Brugada syndrome. J Cardiovasc Electrophysiol. 2006;17:857–864
  34. Stokoe KS, Balasubramaniam R, Goddard CA, Colledge WH, Grace AA, Huang CL. Effects of flecainide and quinidine on arrhythmogenic properties of Scn5a+/– murine hearts. J Physiol. 2007;581:255–275
  35. Takenaka S, Emori T, Koyama S, Morita H, Fukushima K, Ohe T. Asymptomatic form of Brugada syndrome. Pacing Clin Electrophysiol. 1999;22:1261–1263
  36. Fujiki A, Usui M, Nagasawa H, Mizumaki K, Hayashi H, Inoue H. ST segment elevation in the right precordial leads induced with class IC antiarrhythmic drugs: insight into the mechanism of Brugada syndrome. J Cardiovasc Electrophysiol. 1999;10:214–218
  37. Takagi M, Doi A, Takeuchi K, Yoshikawa J. Pilsicanide-induced marked T wave alternans and ventricular fibrillation in a patient with Brugada syndrome. J Cardiovasc Electrophysiol. 2002;13:837
  38. Kimura M, Kobayashi T, Owada S, et al. Mechanism of ST elevation and ventricular arrhythmias in an experimental Brugada syndrome model. Circulation. 2004;109:125–131
  39. Joshi S, Raiszadeh F, Pierce W, Steinberg JS. Antiarrhythmic induced electrical storm in Brugada syndrome: a case report. Ann Noninvasive Electrocardiol. 2007;12:274–278
  40. Villemaire C, Savard P, Talajic M, Nattel S. A quantitative analysis of use-dependent ventricular conduction slowing by procainamide in anesthetized dogs. Circulation. 1992;85:2255–2266
  41. Matana A, Goldner V, Stanic K, Mavric Z, Zaputovic L, Matana Z. Unmasking effect of propafenone on the concealed form of the Brugada phenomenon. Pacing Clin Electrophysiol. 2000;23:416–418
  42. Akdemir I, Davutoglu V, Aksoy M. Intermittent Brugada syndrome misdiagnosed as acute myocardial infarction and unmasked with propafenone. Heart. 2002;87:543
  43. Hasdemir C, Olukman M, Ulucan C, Roden DM. Brugada-type ECG pattern and extreme QRS complex widening with propafenone overdose. J Cardiovasc Electrophysiol. 2006;17:565–566
  44. Shan Q, Yang B, Chen M, et al. Short-term normalization of ventricular repolarization by transcatheter ablation in a patient with suspected Brugada Syndrome. J Interv Card Electrophysiol. 2008;21:53–57
  45. Stark U, Stark G, Poppe H, et al. Rate-dependent effects of detajmium and propafenone on ventricular conduction and refractoriness in isolated guinea pig hearts. J Cardiovasc Pharmacol. 1996;27:125–131
  46. Bolognesi R, Tsialtas D, Vasini P, Conti M, Manca C. Abnormal ventricular repolarization mimicking myocardial infarction after heterocyclic antidepressant overdose. Am J Cardiol. 1997;79:242–245
  47. Rouleau F, Asfar P, Boulet S, et al. Transient ST segment elevation in right precordial leads induced by psychotropic drugs: relationship to the Brugada syndrome. J Cardiovasc Electrophysiol. 2001;12:61–65
  48. Bebarta VS, Phillips S, Eberhardt A, Calihan KJ, Waksman JC, Heard K. Incidence of Brugada electrocardiographic pattern and outcomes of these patients after intentional tricyclic antidepressant ingestion. Am J Cardiol. 2007;100:656–660
  49. Nau C, Seaver M, Wang SY, Wang GK. Block of human heart hH1 sodium channels by amitriptyline. J Pharmacol Exp Ther. 2000;292:1015–1023
  50. Goldgran-Toledano D, Sideris G, Kevorkian JP. Overdose of cyclic antidepressants and the Brugada syndrome. N Engl J Med. 2002;346:1591–1592
  51. Pacher P, Bagi Z, Lako-Futo Z, Ungvari Z, Nanasi PP, Kecskemeti V. Cardiac electrophysiological effects of citalopram in guinea pig papillary muscle comparison with clomipramine. Gen Pharmacol. 2000;34:17–23
  52. Babaliaros VC, Hurst JW. Tricyclic antidepressants and the Brugada syndrome: an example of Brugada waves appearing after the administration of desipramine. Clin Cardiol. 2002;25:395–398
  53. Chow BJ, Gollob M, Birnie D. Brugada syndrome precipitated by a tricyclic antidepressant. Heart. 2005;91:651
  54. Akhtar M, Goldschlager NF. Brugada electrocardiographic pattern due to tricyclic antidepressant overdose. J Electrocardiol. 2006;39:336–339
  55. Sudoh Y, Cahoon EE, Gerner P, Wang GK. Tricyclic antidepressants as long-acting local anesthetics. Pain. 2003;103:49–55
  56. Darbar D, Yang T, Churchwell K, Wilde AA, Roden DM. Unmasking of Brugada syndrome by lithium. Circulation. 2005;112:1527–1531
  57. Kinugawa T, Kotake H, Mashiba H. Inhibitory actions of amoxapine, a tricyclic antidepressant agent, on electrophysiological properties of mammalian isolated cardiac preparations. Br J Pharmacol. 1988;94:1250–1256
  58. Tada H, Sticherling C, Oral H, Morady F. Brugada syndrome mimicked by tricyclic antidepressant overdose. J Cardiovasc Electrophysiol. 2001;12:275
  59. Muir WW, Strauch SM, Schaal SF. Effects of tricyclic antidepressant drugs on the electrophysiological properties of dog Purkinje fibers. J Cardiovasc Pharmacol. 1982;4:82–90
  60. Klockner U, Isenberg G. Calmodulin antagonists depress calcium and potassium currents in ventricular and vascular myocytes. Am J Physiol Heart Circ Physiol. 1987;253:H1601–H1611
  61. Phillips N, Priestley M, Denniss AR, Uther JB. Brugada-type electrocardiographic pattern induced by epidural bupivacaine. Anesth Analg. 2003;97:264–267table
  62. Vernooy K, Delhaas T, Cremer OL, et al. Electrocardiographic changes predicting sudden death in propofol-related infusion syndrome. Heart Rhythm. 2006;3:131–137
  63. de La Coussaye JE, Brugada J, Allessie MA. Electrophysiologic and arrhythmogenic effects of bupivacaine (A study with high-resolution ventricular epicardial mapping in rabbit hearts). Anesthesiology. 1992;77:132–141
  64. Berman MF, Lipka LJ. Relative sodium current block by bupivacaine and lidocaine in neonatal rat myocytes. Anesth Analg. 1994;79:350–356
  65. Inamura M, Okamoto H, Kuroiwa M, Hoka S. General anesthesia for patients with Brugada syndrome (A report of six cases). Can J Anaesth. 2005;52:409–412
  66. Saint DA. The effects of propofol on macroscopic and single channel sodium currents in rat ventricular myocytes. Br J Pharmacol. 1998;124:655–662
  67. Robinson JD, Melman Y, Walsh EP. Cardiac conduction disturbances and ventricular tachycardia after prolonged propofol infusion in an infant. Pacing Clin Electrophysiol. 2008;31:1070–1073
  68. Noda T, Shimizu W, Taguchi A, et al. ST-segment elevation and ventricular fibrillation without coronary spasm by intracoronary injection of acetylcholine and/or ergonovine maleate in patients with Brugada syndrome. J Am Coll Cardiol. 2002;40:1841–1847
  69. Montgomery PR, Dresel PE. Conduction defects in experimental atrial arrhythmia. Am Heart J. 1974;88:191–197
  70. Shimada M, Miyazaki T, Miyoshi S, et al. Sustained monomorphic ventricular tachycardia in a patient with Brugada syndrome. Jpn Circ J. 1996;60:364–370
  71. Habuchi Y, Furukawa T, Tanaka H, Lu LL, Morikawa J, Yoshimura M. Ethanol inhibition of Ca2+ and Na+ currents in the guinea-pig heart. Eur J Pharmacol. 1995;292:143–149
  72. Littmann L, Monroe MH, Svenson RH. Brugada-type electrocardiographic pattern induced by cocaine. Mayo Clin Proc. 2000;75:845–849
  73. Ortega-Carnicer J, Bertos-Polo J, Gutierrez-Tirado C. Aborted sudden death, transient Brugada pattern, and wide QRS dysrhythmias after massive cocaine ingestion. J Electrocardiol. 2001;34:345–349
  74. Bebarta VS, Summers S. Brugada electrocardiographic pattern induced by cocaine toxicity. Ann Emerg Med. 2007;49:827–829
  75. Xu YQ, Crumb WJ, Clarkson CW. Cocaethylene, a metabolite of cocaine and ethanol, is a potent blocker of cardiac sodium channels. J Pharmacol Exp Ther. 1994;271:319–325
  76. Muller-Schweinitzer E. The mechanism of ergometrine-induced coronary arterial spasm: in vitro studies on canine arteries. J Cardiovasc Pharmacol. 1980;2:645–655
  77. Chalvidan T, Deharo JC, Dieuzaide P, Defaye P, Djiane P. Near fatal electrical storm in a patient equipped with an implantable cardioverter defibrillator for Brugada syndrome. Pacing Clin Electrophysiol. 2000;23:410–412
  78. Paul G, Yusuf S, Sharma S. Unmasking of the Brugada syndrome phenotype during the acute phase of amiodarone infusion. Circulation. 2006;114:e489–e491
  79. Wu L, Rajamani S, Shryock JC, et al. Augmentation of late sodium current unmasks the proarrhythmic effects of amiodarone. Cardiovasc Res. 2008;77:481–488
  80. Tada H, Nogami A, Shimizu W, et al. ST segment and T wave alternans in a patient with Brugada syndrome. Pacing Clin Electrophysiol. 2000;23:413–415
  81. Sarkozy A, Caenepeel A, Geelen P, Peytchev P, de ZM, Brugada P. Cibenzoline induced Brugada ECG pattern. Europace. 2005;7:537–539
  82. Niwa R, Honjo H, Kodama I, Maruyama K, Toyama J. Na+ channel blocking effects of cibenzoline on guinea-pig ventricular cells. Eur J Pharmacol. 1998;352:317–327
  83. Chinushi M, Aizawa Y, Ogawa Y, Shiba M, Takahashi K. Discrepant drug action of disopyramide on ECG abnormalities and induction of ventricular arrhythmias in a patient with Brugada syndrome. J Electrocardiol. 1997;30:133–136
  84. Shimizu W, Antzelevitch C, Suyama K, et al. Effect of sodium channel blockers on ST segment, QRS duration, and corrected QT interval in patients with Brugada syndrome. J Cardiovasc Electrophysiol. 2000;11:1320–1329
  85. Grant AO, Chandra R, Keller C, Carboni M, Starmer CF. Block of wild-type and inactivation-deficient cardiac sodium channels IFM/QQQ stably expressed in mammalian cells. Biophys J. 2000;79:3019–3035
  86. Barajas-Martinez HM, Hu D, Cordeiro JM, et al. Lidocaine-induced Brugada syndrome phenotype linked to a novel double mutation in the cardiac sodium channel. Circ Res. 2008;103:396–404
  87. Aouate P, Clerc J, Viard P, Seoud J. Propranolol intoxication revealing a Brugada syndrome. J Cardiovasc Electrophysiol. 2005;16:348–351
  88. Shimada M, Nakamura Y, Iwanaga S, et al. Nonischemic ST-segment elevation induced by negative inotropic agents. Jpn Circ J. 1999;63:610–616
  89. Chinushi M, Tagawa M, Nakamura Y, Aizawa Y. Shortening of the ventricular fibrillatory intervals after administration of verapamil in a patient with Brugada syndrome and vasospastic angina. J Electrocardiol. 2006;39:331–335
  90. Fish JM, Antzelevitch C. Cellular Mechanism and arrhythmogenic ootential of T-wave alternans in the Brugada syndrome. J Cardiovasc Electrophysiol. 2008;19:301–308
  91. Megarbane B, Leprince P, Deye N, et al. Extracorporeal life support in a case of acute carbamazepine poisoning with life-threatening refractory myocardial failure. Intensive Care Med. 2006;32:1409–1413
  92. Brau ME, Dreimann M, Olschewski A, Vogel W, Hempelmann G. Effect of drugs used for neuropathic pain management on tetrodotoxin-resistant Na(+) currents in rat sensory neurons. Anesthesiology. 2001;94:137–144
  93. Crumb W, Llorca PM, Lancon C, Thomas GP, Garay RP, Hameg A. Effects of cyamemazine on hERG, INa, ICa, Ito, Isus and IK1 channel currents, and on the QTc interval in guinea pigs. Eur J Pharmacol. 2006;532:270–278
  94. Muir WW, Strauch SM, Schaal SF. Effects of tricyclic antidepressant drugs on the electrophysiological properties of drug Purkinje fibers. J Cardiovasc Pharmacol. 1982;4:82–90
  95. Robert E, Bruelle P, de La Coussaye JE, et al. Electrophysiologic and proarrhythmogenic effects of therapeutic and toxic doses of imipramine: a study with high resolution ventricular epicardial mapping in rabbit hearts. J Pharmacol Exp Ther. 1996;278:170–178
  96. Igawa O, Kotake H, Kurata Y, et al. Electrophysiological effects of maprotiline, a tetracyclic antidepressant agent, on isolated cardiac preparations. J Cardiovasc Pharmacol. 1988;11:167–173
  97. Bebarova M, Matejovic P, Pasek M, et al. Effect of antipsychotic drug perphenazine on fast sodium current and transient outward potassium current in rat ventricular myocytes. Naunyn Schmiedebergs Arch Pharmacol. 2009;380:125–133
  98. Al Aloul B, Adabag AS, Houghland MA, Tholakanahalli V. Brugada pattern electrocardiogram associated with supratherapeutic phenytoin levels and the risk of sudden death. Pacing Clin Electrophysiol. 2007;30:713–715
  99. Xu YQ, Pickoff AS, Clarkson CW. Evidence for developmental changes in sodium channel inactivation gating and sodium channel block by phenytoin in rat cardiac myocytes. Circ Res. 1991;69:644–656
  100. Copetti R, Proclemer A, Pillinini PP. Brugada-like ECG abnormalities during thioridazine overdose. Br J Clin Pharmacol. 2005;59:608
  101. Itoh E, Suzuki K, Tanabe Y. A case of vasospastic angina presenting Brugada-type ECG abnormalities. Jpn Circ J. 1999;63:493–495
  102. Sasaki T, Niwano S, Kitano Y, Izumi T. Two cases of Brugada syndrome associated with spontaneous clinical episodes of coronary vasospasm. Intern Med. 2006;45:77–80
  103. Miyazaki K, Adaniya H, Sawanobori T, Hiraoka M. Electrophysiological effects of clentiazem, a new Ca2+ antagonist, on rabbit hearts. J Cardiovasc Pharmacol. 1996;27:615–621
  104. Robert E, Aya AG, de La Coussaye JE, et al. Dispersion-based reentry: mechanism of initiation of ventricular tachycardia in isolated rabbit hearts. Am J Physiol. 1999;276:H413–H423
  105. Hussain M, Orchard CH. Sarcoplasmic reticulum Ca2+ content, L-type Ca2+ current and the Ca2+ transient in rat myocytes during beta-adrenergic stimulation. J Physiol. 1997;505(Pt 2):385–402
  106. Matsuo K, Shimizu W, Kurita T, Inagaki M, Aihara N, Kamakura S. Dynamic changes of 12-lead electrocardiograms in a patient with Brugada syndrome. J Cardiovasc Electrophysiol. 1998;9:508–512
  107. Korth M. Influence of glyceryl trinitrate on force of contraction and action potential of guinea-pig myocardium. Naunyn Schmiedebergs Arch Pharmacol. 1975;287:329–347
  108. Atanassova R, Spassov G, Balansky R, Boev K. Effects of isosorbide-5-mononitrate and isosorbide-2-mononitrate on the contractile and electrical activity and on the content of cyclic nucleotides in isolated heart muscles of the guinea-pig and dog. J Pharm Pharmacol. 1992;44:663–666
  109. Pastor A, Nunez A, Cantale C, Cosio FG. Asymptomatic Brugada syndrome case unmasked during dimenhydrinate infusion. J Cardiovasc Electrophysiol. 2001;12:1192–1194
  110. Lopez-Barbeito B, Lluis M, Delgado V, et al. Diphenhydramine overdose and Brugada sign. Pacing Clin Electrophysiol. 2005;28:730–732
  111. Kuo CC, Huang RC, Lou BS. Inhibition of Na(+) current by diphenhydramine and other diphenyl compounds: molecular determinants of selective binding to the inactivated channels. Mol Pharmacol. 2000;57:135–143
  112. Mok NS, Tong CK, Yuen HC. Concomitant-acquired Long QT and Brugada syndromes associated with indapamide-induced hypokalemia and hyponatremia. Pacing Clin Electrophysiol. 2008;31:772–775
  113. Watanabe A, Kusano KF, Morita H, et al. Low-dose isoproterenol for repetitive ventricular arrhythmia in patients with Brugada syndrome. Eur Heart J. 2006;27:1579–1583
  114. Ganesan AN, Maack C, Johns DC, Sidor A, O'Rourke B. Beta-adrenergic stimulation of L-type Ca2+ channels in cardiac myocytes requires the distal carboxyl terminus of alpha1C but not serine 1928. Circ Res. 2006;98:e11–e18
  115. Kyriazis K, Bahlmann E, van der SH, Kuck KH. Electrical storm in Brugada syndrome successfully treated with orciprenaline; effect of low-dose quinidine on the electrocardiogram. Europace. 2009;11:665–666
  116. Alings M, Dekker L, Sadee A, Wilde A. Quinidine induced electrocardiographic normalization in two patients with Brugada syndrome. Pacing Clin Electrophysiol. 2001;24:1420–1422
  117. Yan GX, Antzelevitch C. Cellular basis for the Brugada syndrome and other mechanisms of arrhythmogenesis associated with ST-segment elevation. Circulation. 1999;100:1660–1666
  118. Tsuchiya T, Ashikaga K, Honda T, Arita M. Prevention of ventricular fibrillation by cilostazol, an oral phosphodiesterase inhibitor, in a patient with Brugada syndrome. J Cardiovasc Electrophysiol. 2002;13:698–701
  119. Abud A, Bagattin D, Goyeneche R, Becker C. Failure of cilostazol in the prevention of ventricular fibrillation in a patient with Brugada syndrome. J Cardiovasc Electrophysiol. 2006;17:210–212
  120. Matsui K, Kiyosue T, Wang JC, Dohi K, Arita M. Effects of pimobendan on the L-type Ca2+ current and developed tension in guinea-pig ventricular myocytes and papillary muscle: comparison with IBMX, milrinone, and cilostazol. Cardiovasc Drugs Ther. 1999;13:105–113

 This study was supported by The Netherlands Heart Foundation Grant 2005T024 to Dr. Postema; Fondation Leducq Trans-Atlantic Network of Excellence, Preventing Sudden Death Grant 05-CVD-01 to Dr. Wilde; CHU de Nantes, France, and Société Française de Cardiologie Grant P.H.R.C. 2004 R20/07 to Dr. Probst; and National Institutes of Health Grant HL65962 to Dr. Roden.

PII: S1547-5271(09)00739-5

doi: 10.1016/j.hrthm.2009.07.002

Heart Rhythm
Volume 6, Issue 9 , Pages 1335-1341 , September 2009

Article Tools

* Image Usage & Resolution