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Related Experiment Video

Updated: Dec 10, 2025

Microelectrode Array Recording of Sinoatrial Node Firing Rate to Identify Intrinsic Cardiac Pacemaking Defects in Mice
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Ajmaline Testing and the Brugada Syndrome.

Alessandro Rizzo1, Gianluca Borio1, Juan Sieira1

  • 1Heart Rhythm Management Center, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium; European Reference Networks Guard-Heart, Brussels, Belgium.

The American Journal of Cardiology
|August 31, 2020
PubMed
Summary
This summary is machine-generated.

Brugada syndrome (BrS) diagnosis is challenging due to ECG variability. Ajmaline challenge revealed a high prevalence of BrS in patients undergoing electrophysiological evaluation for various cardiac symptoms, enabling better patient management.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Genetics

Background:

  • Brugada syndrome (BrS) diagnosis relies on a type 1 ECG pattern, but prevalence is unclear due to spontaneous ECG variability.
  • The ajmaline challenge is a provocative test used to unmask the BrS ECG pattern.

Purpose of the Study:

  • To evaluate the prevalence of a positive ajmaline challenge for BrS in consecutive patients undergoing electrophysiological evaluation.
  • To assess the clinical characteristics and outcomes of patients with a positive ajmaline challenge.

Main Methods:

  • Prospective inclusion of 2,456 consecutive patients undergoing ajmaline testing between 2008 and 2019.
  • Analysis of ajmaline test results, patient demographics, clinical indications, and follow-up data.
  • Comparison of characteristics between patients with positive and negative ajmaline tests.

Main Results:

  • In the non-familial screening group (1,714 patients), 10.9% (186 patients) had a positive ajmaline test.
  • Positive ajmaline test patients were younger and more frequently male compared to the overall population.
  • Syncope was the most common indication for ajmaline testing (38.2%) in patients with positive results.

Conclusions:

  • Brugada syndrome was diagnosed in a higher-than-expected proportion of patients undergoing ajmaline testing for diverse cardiovascular symptoms.
  • These findings highlight the utility of ajmaline challenge in diagnosing BrS and guiding clinical management and counseling.