Publication: The utility of drug challenge testing in Brugada syndrome: A systematic review and meta-analysis
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Issued Date
2020-01-01
Resource Type
ISSN
15408167
10453873
10453873
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2-s2.0-85087685561
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Cardiovascular Electrophysiology. (2020)
Suggested Citation
Pattara Rattanawong, Jakrin Kewcharoen, Chanavuth Kanitsoraphan, Wasawat Vutthikraivit, Prapaipan Putthapiban, Narut Prasitlumkum, Poemlarp Mekraksakit, Raktham Mekritthikrai, Eugene H. Chung The utility of drug challenge testing in Brugada syndrome: A systematic review and meta-analysis. Journal of Cardiovascular Electrophysiology. (2020). doi:10.1111/jce.14631 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/58327
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Title
The utility of drug challenge testing in Brugada syndrome: A systematic review and meta-analysis
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.