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Title: The utility of drug challenge testing in Brugada syndrome: A systematic review and meta-analysis
Authors: Pattara Rattanawong
Jakrin Kewcharoen
Chanavuth Kanitsoraphan
Wasawat Vutthikraivit
Prapaipan Putthapiban
Narut Prasitlumkum
Poemlarp Mekraksakit
Raktham Mekritthikrai
Eugene H. Chung
Texas Tech University Health Sciences Center at Lubbock
Albert Einstein Healthcare Network
Mayo Clinic Scottsdale-Phoenix, Arizona
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
University of Hawaiʻi at Mānoa
Michigan Medicine
Keywords: Medicine
Issue Date: 1-Jan-2020
Citation: Journal of Cardiovascular Electrophysiology. (2020)
Abstract: © 2020 Wiley Periodicals LLC Introduction: Brugada syndrome (BrS) is associated with ventricular arrhythmia leading to sudden cardiac death. Risk stratification is challenging, as major arrhythmic events (MAEs) are rare. We assessed the utility of drug challenge testing in BrS by a systematic review and meta-analysis. Methods and Results: We comprehensively searched the databases of MEDLINE and EMBASE from inception to May 2019. Included studies compared the incidence of MAE between spontaneous and drug challenge–induced Type 1. Mixed-effects Poisson regression was used to calculate the incidence rate ratio (IRR). Eighteen studies from 2006 to 2018 were included (4099 patients, mean follow-up: 4.5 years). Pooled annual incidences of MAE in spontaneous, drug challenge induced (regardless of symptoms), asymptomatic drug challenge induced, and symptomatic drug challenge–induced Type 1 were 23.8 (95% confidence interval [CI]: 19.8–27.8), 6.5 (95% CI: 3.9–9.1), 2.1 (95% CI: −0.3 to 4.4), and 19.6 (95% CI: 9.9–29.3) per 1000 person-years, respectively. The incidence of MAE between symptomatic drug challenge induced and asymptomatic spontaneous Type 1 was not statistically different (IRR = 1.0; 95% CI: 0.6–1.7). Conclusions: The incidence of MAE in drug challenge–induced Type 1 in asymptomatic patients is low. The incidence of MAE between symptomatic drug challenge induced and asymptomatic spontaneous Type 1 was similar.
ISSN: 15408167
Appears in Collections:Scopus 2020

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