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https://www.readbyqxmd.com/read/28521022/management-of-untreatable-ventricular-arrhythmias-during-pharmacologic-challenges-with-sodium-channel-blockers-for-suspected-brugada-syndrome
#1
Stefano Poli, Mauro Toniolo, Massimo Maiani, Davide Zanuttini, Luca Rebellato, Igor Vendramin, Ermanno Dametto, Guglielmo Bernardi, Flavio Bassi, Carlo Napolitano, Ugolino Livi, Alessandro Proclemer
Pharmacologic challenge with sodium channel blockers is part of the diagnostic workout in patients with suspected Brugada syndrome. The test is overall considered safe but both ajmaline and flecainide detain well known pro-arrhythmic properties. Moreover, the treatment of patients with life-threatening arrhythmias during these diagnostic procedures is not well defined. Current consensus guidelines suggest to adopt cautious protocols interrupting the sodium channel blockers as soon as any ECG alteration appears...
May 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28500178/electrical-substrate-elimination-in-135-consecutive-patients-with-brugada-syndrome
#2
Carlo Pappone, Josep Brugada, Gabriele Vicedomini, Giuseppe Ciconte, Francesco Manguso, Massimo Saviano, Raffaele Vitale, Amarild Cuko, Luigi Giannelli, Zarko Calovic, Manuel Conti, Paolo Pozzi, Andrea Natalizia, Simonetta Crisà, Valeria Borrelli, Ramon Brugada, Georgia Sarquella-Brugada, Marco Guazzi, Alessandro Frigiola, Lorenzo Menicanti, Vincenzo Santinelli
BACKGROUND: There is emerging evidence that localization and elimination of abnormal electric activity in the epicardial right ventricular outflow tract may be beneficial in patients with Brugada syndrome. METHODS AND RESULTS: A total of 135 symptomatic Brugada syndrome patients having implantable cardiac defibrillator were enrolled: 63 (group 1) having documented ventricular tachycardia (VT)/ventricular fibrillation (VF) and Brugada syndrome-related symptoms, and 72 (group 2) having inducible VT/VF without ECG documentation at the time of symptoms...
May 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28436550/epicardial-brugada-syndrome-ablation-unmasking-inferior-j-waves
#3
Adam Lee, Heidi Kohler, Daniel Wright, Haris M Haqqani
Patients with Brugada syndrome are at risk of life threatening ventricular arrhythmias. Epicardial substrate ablation for Brugada syndrome has been described as a means of controlling these arrhythmias and recent reports describe elimination of the Brugada phenotype with ablation. We describe a unique case in which a patient developed inferior J waves with an early repolarization-type electrocardiogram following successful epicardial infundibular substrate ablation (which eliminated the Brugada syndrome ECG on ajmaline challenge)...
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28419221/should-all-individuals-with-a-non-diagnostic-electrocardiogram-undergo-ajmaline-challenge-to-unmask-the-concealed-arrhythmic-overlap-syndromes
#4
Ahmet Vedat Kavurt, Ozcan Ozeke, Serkan Cay, Serkan Topaloglu, Dursun Aras
No abstract text is available yet for this article.
April 12, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28381391/brugada-phenocopy-induced-by-propafenone-overdose-and-successful-treatment-a-case-report
#5
Mehmet Emre Arı, Filiz Ekici
BACKGROUND: Brugada syndrome is an inherited arrhythmogenic disease that may cause sudden cardiac death due to ventricular fibrillation in young adults. Brugada syndrome caused by propafenone intoxication has been noted rarely in the literature. We reported a rare case, Brugada-phenocopy due to propafenone intoxication and its treatment. CASE REPORT: A fifteen-year-old girl having a seizure was brought to the emergency room. She took 1.5 g propafenone (Rythmol, Abbott, Chicago, IL, USA) for suicidal intention...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28344931/proarrhythmogenic-effects-of-lamotrigine-during-ajmaline-testing-for-brugada-syndrome
#6
Kevin M W Leong, Henry Seligman, Amanda M Varnava
No abstract text is available yet for this article.
March 2017: HeartRhythm Case Reports
https://www.readbyqxmd.com/read/28340026/high-rate-of-subcutaneous-implantable-cardioverter-defibrillator-sensing-screening-failure-in-patients-with-brugada-syndrome-a-comparison-with-other-inherited-primary-arrhythmia-syndromes
#7
Giulio Conte, Mihoko Kawabata, Carlo de Asmundis, Erika Taravelli, Francesco Petracca, Diego Ruggiero, Maria Luce Caputo, François Regoli, Gian-Battista Chierchia, Alessandra Chiodini, Alessandro Del Bufalo, Tiziano Moccetti, Masahiko Goya, Kenzo Hirao, Alessandro Vicentini, Gaetano M De Ferrari, Pedro Brugada, Angelo Auricchio
Aims: Subcutaneous implantable cardioverter-defibrillator (S-ICD) can avoid important complications associated with transvenous leads in patients with inherited primary arrhythmia syndromes, who do not need pacing therapy. Few data are available on the percentage of patients with inherited arrhythmia syndromes eligible for S-ICD implantation. Aim of this study was to analyse the eligibility for S-ICD in a series of patients with Brugada syndrome (BrS), and to compare it with patients with other channelopathies...
March 7, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27915266/systematic-ajmaline-challenge-in-patients-with-long-qt-3-syndrome-caused-by-the-most-common-mutation-a-multicentre-study
#8
Stephan Hohmann, Boris Rudic, Torsten Konrad, David Duncker, Thorben König, Erol Tülümen, Thomas Rostock, Martin Borggrefe, Christian Veltmann
AIMS: Overlap syndromes of long QT 3 syndrome (LQT3) and the Brugada syndrome (BrS) have been reported. Identification of patients with an overlapping phenotype is crucial before initiation of Class I antiarrhythmic drugs for LQT3. Aim of the present study was to elucidate the yield of ajmaline challenge in unmasking the Brugada phenotype in patients with LQT3 caused by the most common mutation, SCN5A-E1784K. METHODS AND RESULTS: Consecutive families in tertiary referral centres diagnosed with LQT3 caused by SCN5A-E1784K were included in the study...
December 2, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27909532/ajmaline-challenge-to-unmask-infrahisian-disease-in-patients-with-recurrent-and-unexplained-syncope-preserved-ejection-fraction-with-or-without-conduction-abnormalities-on-surface-ecg
#9
Francesco Pentimalli, Luca Bacino, Matteo Ghione, Giambattista Siri, Massimo Gazzarata, Paolo Bellotti
Background: Pharmacological challenge with class I antiarrhythmic drug is a recommended diagnostic test in patients with unexplained syncope only in the presence of bundle branch block, when non-invasive tests have failed to make the diagnosis. Its role in patients with minor or no conduction disturbances on 12-leads ECG has not been evaluated yet. It is also not clear which are the values of His-Ventricular interval to be considered diagnostic. We sought to evaluate the role of ajmaline challenge in unmasking the presence of an infrahisian disease in patients with recurrent and unexplained syncope, regardless of the existence of conduction disturbances on surface ECG...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909514/influence-of-novel-electrocardiographic-features-of-provocable-brugada-ecg-in-arrhythmogenic-cardiomyopathy-and-its-exclusion-by-lead-avr
#10
REVIEW
Stefan Peters
In 19 patients (14 females, mean age 49.1 ± 11.3 years) with typical arrhythmogenic cardiomyopathy and provocable type I Brugada ECG pattern by ajmaline administration were analysed by novel electrocardiographic features as having "true" or "false" Brugada syndrome. Three patients turned out as having false Brugada syndrome, the diagnosis is pure arrhythmogenic cardiomyopathy. In 16 patients, however, true Brugada syndrome could be provoked. In these patients the diagnosis was arrhythmogenic cardiomyopathy associated by provocable Brugada syndrome...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27854259/synthesis-of-bisindole-alkaloids-from-the-apocynaceae-which-contain-a-macroline-or-sarpagine-unit-a-review
#11
REVIEW
Md Toufiqur Rahman, Veera V N Phani Babu Tiruveedhula, James M Cook
Bisindole natural products consist of two monomeric indole alkaloid units as their obligate constituents. Bisindoles are more potent with respect to their biological activity than their corresponding monomeric units. In addition, the synthesis of bisindoles are far more challenging than the synthesis of monomeric indole alkaloids. Herein is reviewed the enantiospecific total and partial synthesis of bisindole alkaloids isolated primarily from the Alstonia genus of the Apocynaceae family. The monomeric units belong to the sarpagine, ajmaline, macroline, vobasine, and pleiocarpamine series...
November 14, 2016: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/27829006/hyperthermia-influences-the-effects-of-sodium-channel-blocking-drugs-in-human-induced-pluripotent-stem-cell-derived-cardiomyocytes
#12
Ibrahim El-Battrawy, Siegfried Lang, Zhihan Zhao, Ibrahim Akin, Gökhan Yücel, Sophie Meister, Bence Patocskai, Michael Behnes, Boris Rudic, Erol Tülümen, Volker Liebe, Malte Tiburcy, Jennifer Dworacek, Wolfram-Hubertus Zimmermann, Jochen Utikal, Thomas Wieland, Martin Borggrefe, Xiao-Bo Zhou
INTRODUCTION: Fever can increase the susceptibility to supraventricular and ventricular arrhythmias, in which sodium channel dysfunction has been implicated. Whether fever influences the efficacy of sodium channel blocking drugs is unknown. The current study was designed to investigate the temperature dependent effects of distinct sodium channel blocking drugs on the sodium currents in human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). METHODS AND RESULTS: hiPSC-CMs were generated from human skin fibroblasts of a healthy donor...
2016: PloS One
https://www.readbyqxmd.com/read/27632082/systems-biology-based-investigation-of-cellular-antiviral-drug-targets-identified-by-gene-trap-insertional-mutagenesis
#13
Feixiong Cheng, James L Murray, Junfei Zhao, Jinsong Sheng, Zhongming Zhao, Donald H Rubin
Viruses require host cellular factors for successful replication. A comprehensive systems-level investigation of the virus-host interactome is critical for understanding the roles of host factors with the end goal of discovering new druggable antiviral targets. Gene-trap insertional mutagenesis is a high-throughput forward genetics approach to randomly disrupt (trap) host genes and discover host genes that are essential for viral replication, but not for host cell survival. In this study, we used libraries of randomly mutagenized cells to discover cellular genes that are essential for the replication of 10 distinct cytotoxic mammalian viruses, 1 gram-negative bacterium, and 5 toxins...
September 2016: PLoS Computational Biology
https://www.readbyqxmd.com/read/27563218/elicitation-based-enhancement-of-secondary-metabolites-in-rauwolfia-serpentina-and-solanum-khasianum-hairy-root-cultures
#14
Mrinalini Srivastava, Swati Sharma, Pratibha Misra
BACKGROUND: Rauwolfia serpentina and Solanum khasianum are well-known medicinally important plants contained important alkaloids in their different parts. Elicitation of these alkaloids is important because of associated pharmaceutical properties. Targeted metabolites were ajmaline and ajmalicine in R. serpentina; solasodine and α-solanine in S. khasianum. OBJECTIVE: Enhancement of secondary metabolites through biotic and abiotic elicitors in hairy root cultures of R...
May 2016: Pharmacognosy Magazine
https://www.readbyqxmd.com/read/27437669/simultaneous-determination-of-bioactive-monoterpene-indole-alkaloids-in-ethanolic-extract-of-seven-rauvolfia-species-using-uhplc-with-hybrid-triple-quadrupole-linear-ion-trap-mass-spectrometry
#15
Sunil Kumar, Awantika Singh, Vikas Bajpai, Mukesh Srivastava, Bhim Pratap Singh, Sanjeev Ojha, Brijesh Kumar
INTRODUCTION: Rauvolfia serpentina is an endangered plant species due to its over-exploitation. It has highly commercial and economic importance due to the presence of bioactive monoterpene indole alkaloids (MIAs) such as ajmaline, yohimbine, ajmalicine, serpentine and reserpine. OBJECTIVE: To develop a validated, rapid, sensitive and selective ultra-high-performance liquid chromatography coupled with hybrid triple quadrupole-linear ion trap mass spectrometry (UHPLC-QqQLIT -MS/MS) method in the multiple reaction monitoring (MRM) mode for simultaneous determination of bioactive MIAs in ethanolic extract of seven Rauvolfia species and herbal formulations...
September 2016: Phytochemical Analysis: PCA
https://www.readbyqxmd.com/read/27342343/death-related-to-consumption-of-rauvolfia-sp-powder-mislabeled-as-tabernanthe-iboga
#16
Thomas Gicquel, Chloé Hugbart, Françoise Le Devehat, Sylvie Lepage, Alain Baert, Renaud Bouvet, Isabelle Morel
Powdered roots of iboga (Tabernanthe iboga) contain ibogaine, an alkaloid that has been used to treat addictions. We report the case of a 30-year-old woman who died after ingesting a powder labeled as Tabernanthe iboga she had bought online. Analysis of the powder revealed the absence of ibogaine but the presence of toxic alkaloids (ajmaline, yohimbine and reserpine) found in Rauvolfia sp. plant species. An original and specific LC-MS/MS method developed to quantify ajmaline, yohimbine and reserpine showed respective concentrations of 109...
September 2016: Forensic Science International
https://www.readbyqxmd.com/read/27255966/the-prevalence-and-significance-of-the-early-repolarization-pattern-in-sudden-arrhythmic-death-syndrome-families
#17
Greg Mellor, Christopher P Nelson, Claire Robb, Hariharan Raju, Yanushi Wijeyeratne, Christian Hengstenberg, Wibke Reinhard, Michael Papadakis, Sanjay Sharma, Nilesh J Samani, Elijah R Behr
BACKGROUND: The early repolarization (ER) pattern is associated with sudden death and has been shown to be heritable. Its significance when identified in families affected by sudden arrhythmic death syndrome (SADS) remains unclear. METHODS AND RESULTS: We analyzed 12-lead ECGs of 401 first-degree relatives of individuals who had died from SADS. The prevalence of ER patterns was compared with family-clustered controls. ER was more common in SADS family members than in controls (21% versus 8%; odds ratio: 5...
June 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27249611/malignant-ventricular-arrhythmias-induction-by-programmed-electrical-stimulation-of-the-right-ventricular-outflow-tract-only-during-type-1-brugada-ecg-maximization
#18
N Alessandri, B L Nguyen, F Tufano, R Sergiacomi, F Tersigni, F Urciuoli, S De Angelis, A Dei Giudici
OBJECTIVE: The role of electrophysiology study in Brugada syndrome (BS) sudden cardiac death risk stratification remains controversial and seems to depend on the phenotypic expression of the channelopathy. Ajmaline has a key role in the diagnosis of BS. We observed that programmed electrical stimulation (PES) of the right ventricular outflow tract (RVOT), only when type 1 BS ECG is unmasked by ajmaline administration, induces ventricular arrhythmias. CASE REPORT: We describe a case of ventricular fibrillation induction by PES of the RVOT when type 1 BS ECG is revealed by ajmaline, in a patient with a baseline dynamic intermittent type 1 and 2 BS ECG...
May 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27151277/brugada-syndrome-in-the-paediatric-population-a-comprehensive-approach-to-clinical-manifestations-diagnosis-and-management
#19
REVIEW
M Cecilia Gonzalez Corcia, Carlo de Asmundis, Gian-Battista Chierchia, Pedro Brugada
Brugada syndrome is an inherited arrhythmogenic disorder, characterised by coved-type ST-segment elevation in the right precordial leads, and is associated with increased risk of sudden death. It is genetically and clinically heterogeneous, presenting typically in the fourth or fifth decade of life. The prevalence of Brugada syndrome in the paediatric population is low compared with the adult population. Interestingly, over the last several years, there has been growing evidence in the literature of onset of the disease during childhood...
August 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27122470/rauvolfia-serpentina-n-methyltransferases-involved-in-ajmaline-and-n%C3%AE-methylajmaline-biosynthesis-belong-to-a-gene-family-derived-from-%C3%AE-tocopherol-c-methyltransferase
#20
Paulo Cázares-Flores, Dylan Levac, Vincenzo De Luca
Ajmaline biosynthesis in Rauvolfia serpentina has been one of the most studied monoterpenoid indole alkaloid (MIA) pathways within the plant family Apocynaceae. Detailed molecular and biochemical information on most of the steps involved in the pathway has been generated over the last 30 years. Here we report the identification, molecular cloning and functional expression in Escherichia coli of two R. serpentinacDNAs that are part of a recently discovered γ-tocopherol-like N-methyltransferase (γ-TLMT) family and are involved in indole and side-chain N-methylation of ajmaline...
August 2016: Plant Journal: for Cell and Molecular Biology
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