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https://www.readbyqxmd.com/read/29650119/assessing-the-malignant-ventricular-arrhythmic-substrate-in-patients-with-brugada-syndrome
#1
Carlo Pappone, Giuseppe Ciconte, Francesco Manguso, Gabriele Vicedomini, Valerio Mecarocci, Manuel Conti, Luigi Giannelli, Paolo Pozzi, Valeria Borrelli, Lorenzo Menicanti, Zarko Calovic, Giuseppe Della Ratta, Josep Brugada, Vincenzo Santinelli
BACKGROUND: Guidelines recommend the use of implanted cardioverter-defibrillators in patients with Brugada syndrome and induced ventricular tachyarrhythmias, but there is no evidence supporting it. OBJECTIVES: This prospective registry study was designed to explore clinical and electrophysiological predictors of malignant ventricular tachyarrhythmia inducibility in Brugada syndrome. METHODS: A total of 191 consecutive selected patients with (group 1; n = 88) and without (group 2; n = 103) Brugada syndrome-related symptoms were prospectively enrolled in the registry...
April 17, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29560676/cholestatic-hepatitis-after-diagnostic-ajmaline-challenge
#2
C Hamoir, H Dano, M Komuta, P Druez, S Negrin Dastis
We report a cholestatic hepatitis in an elderly woman after ajmaline challenge during electrophysiological testing for Brugada syndrome. No other medication was reported in the previous 6 months of the onset of jaundice. Liver biopsy showed a cholestatic hepatitis with mild biliary damage. Liver enzymes normalized within 2 weeks as well as jaundice. To the best of our knowledge this is the second case of histologically proved cholestatic hepatitis induced by intravenous ajmaline testing.
July 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29544603/the-diagnostic-yield-of-brugada-syndrome-after-sudden-death-with-normal-autopsy
#3
Michael Papadakis, Efstathios Papatheodorou, Greg Mellor, Hariharan Raju, Rachel Bastiaenen, Yanushi Wijeyeratne, Sara Wasim, Bode Ensam, Gherardo Finocchiaro, Belinda Gray, Aneil Malhotra, Andrew D'Silva, Nina Edwards, Della Cole, Virginia Attard, Velislav N Batchvarov, Maria Tome-Esteban, Tessa Homfray, Mary N Sheppard, Sanjay Sharma, Elijah R Behr
BACKGROUND: Familial evaluation after a sudden death with negative autopsy (sudden arrhythmic death syndrome; SADS) may identify relatives at risk of fatal arrhythmias. OBJECTIVES: This study aimed to assess the impact of systematic ajmaline provocation testing using high right precordial leads (RPLs) on the diagnostic yield of Brugada syndrome (BrS) in a large cohort of SADS families. METHODS: Three hundred three SADS families (911 relatives) underwent evaluation with resting electrocardiogram using conventional and high RPLs, echocardiography, exercise, and 24-h electrocardiogram monitor...
March 20, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29513181/cholestatic-hepatitis-after-diagnostic-ajmaline-challenge
#4
C Hamoir, H Dano, M Komuta, P Druez, S N Dastis
We report a cholestatic hepatitis in an elderly woman after ajmaline challenge during electrophysiological testing for Brugada syndrome. No other medication was reported in the previous 6 months of the onset of jaundice. Liver biopsy showed a cholestatic hepatitis with mild biliary damage. Liver enzymes normalized within 2 weeks as well as jaundice. To the best of our knowledge this is the second case of histologically proved cholestatic hepatitis induced by intravenous ajmaline testing.
July 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29424320/reserpine-induces-apoptosis-and-cell-cycle-arrest-in-hormone-independent-prostate-cancer-cells-through-mitochondrial-membrane-potential-failure
#5
Manjula Devi Ramamoorthy, Ashok Kumar, Mahesh Ayyau, Kannan Narayanan Dhiraviam
Reserpine, an indole alkaloid commonly used for hypertension, is found in the roots of Rauwolfia serpentina. Although the root extract has been used for the treatment of cancer, the molecular mechanism of its anti-cancer activity on hormonal independent prostate cancer remains elusive. Therefore, we evaluated the cytotoxicity of reserpine and other indole alkaloids, yohimbine and ajmaline on prostate cancer cells (PC3) using MTT assay. We investigated the mechanism of apoptosis using a combination of techniques including acridine orange/ethidium bromide staining, high content imaging of Annexin V-FITC staining, flow cytometric quantification of the mitochondrial membrane potential and reactive oxygen species (ROS) and cell cycle analysis...
February 9, 2018: Anti-cancer Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/29306474/concealed-abnormal-atrial-phenotype-in-patients-with-brugada-syndrome-and-no-history-of-atrial-fibrillation
#6
Giulio Conte, Maria Luce Caputo, Paul G A Volders, Adrian Luca, Luca Mainardi, Ulrich Schotten, Valentina D A Corino, François Regoli, Stef Zeemering, Matthias Zink, Sasan Yazdani, Lukas Kappenberger, Tiziano Moccetti, Jean-Marc Vesin, Angelo Auricchio
OBJECTIVES: The electrocardiogram (ECG) of patients with BrS in sinus rhythm might reflect intrinsic atrial electrical abnormalities independent from any previous atrial fibrillation (AF). Aim of this study is to investigate the presence of P-wave abnormalities in patients with BrS and no history of AF, and to compare them with those displayed by patients with documented paroxysmal AF and by healthy subjects. METHODS: Continuous 5-min 16-lead ECG recordings in sinus rhythm were obtained from 72 participants: 32 patients with a type 1 Brugada ECG, 20 patients with a history of paroxysmal AF and 20 age-matched healthy subjects...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29304410/simultaneous-quantitative-determination-of-bioactive-terpene-indole-alkaloids-in-ethanolic-extracts-of-catharanthus-roseus-l-g-don-by-ultra-high-performance-liquid-chromatography-tandem-mass-spectrometry
#7
Sunil Kumar, Awantika Singh, Brijesh Kumar, Bikarma Singh, Lal Bahadur, Mohan Lal
A rapid, sensitive and reproducible method using ultra-high-performance liquid chromatography coupled with electrospray ionization hybrid triple quadrupole-linear ion trap mass spectrometry (UHPLC-ESI-QqQLIT -MS/MS) in multiple reaction monitoring (MRM) mode was developed and validated for simultaneous quantitation of anticancer (vincristine, vinblastine, vindesine), antihypertensive (ajmaline, ajmalicine, reserpine), aphrodisiac (yohimbine), sedative (serpentine) agents, dietary supplement (vinpocetine, yohimbine) and precursor of vinblastine (vindoline) from crude extracts of Catharanthus roseus...
March 20, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29244896/total-synthesis-of-sarpagine-related-bioactive-indole-alkaloids
#8
M Toufiqur Rahman, Jeffrey R Deschamps, Gregory H Imler, James M Cook
Extension of the asymmetric Pictet-Spengler reaction to bulkier Nb -alkylated tryptophan derivatives resulted in an improved stereospecific access to the key bicyclo[3.3.1]nonane core of bioactive C-19 methyl substituted sarpagine/macroline/ajmaline indole alkaloids with excellent diastereoselectivity by internal asymmetric induction. Complete stereocontrol of the C-19 methyl function in either the α- or β-configuration was achieved, which enables the total synthesis of any member from this group of thirty alkaloids...
February 16, 2018: Chemistry: a European Journal
https://www.readbyqxmd.com/read/29242054/brugada-phenocopy-induced-by-severe-pneumothorax
#9
Javier C Barcos, Iván A Tello Santacruz, César Cáceres Monié, María L Fernández Recalde, Juan D Humphreys
A Brugada phenocopy has been defined as a clinical situation that presents with an abnormal electrocardiogram identical to any of the electrocardiographic patterns found in Brugada syndrome in the absence of the characteristic congenital genetic abnormalities. The first confirmed case of type 1 Brugada phenocopy associated with severe left pneumothorax is presented. A provocative test with ajmaline, which proved to be negative, was performed to confirm the diagnosis. The presence of ST-segment elevation in the context of pneumothorax is most infrequent...
March 2018: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29215340/a-report-of-brugada-syndrome-presenting-with-cardiac-arrest-triggered-by-verapamil-intoxication
#10
Kahraman Yakut, İlkay Erdoğan, Birgül Varan, İlyas Atar
BACKGROUND: Brugada syndrome is a disease characterized by a specific electrocardiographic pattern and an increased risk of sudden cardiac death. We present this case with the updated literature to emphasise the need to consider the diagnosis of Brugada syndrome in patients admitted to the emergency ward with sudden cardiac arrest. CASE REPORT: A 16-year-old female patient was admitted to the emergency ward with complaints of weakness and abdominal pain, and she had four cardiac arrests during her evaluation period...
December 1, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/29172153/ajmaline-blocks-i-na-and-i-kr-without-eliciting-differences-between-brugada-syndrome-patient-and-control-human-pluripotent-stem-cell-derived-cardiac-clusters
#11
Duncan C Miller, Stephen C Harmer, Ariel Poliandri, Muriel Nobles, Elizabeth C Edwards, James S Ware, Tyson V Sharp, Tristan R McKay, Leo Dunkel, Pier D Lambiase, Andrew Tinker
The class Ia anti-arrhythmic drug ajmaline is used clinically to unmask latent type I ECG in Brugada syndrome (BrS) patients, although its mode of action is poorly characterised. Our aims were to identify ajmaline's mode of action in human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes (CMs), and establish a simple BrS hiPSC platform to test whether differences in ajmaline response could be determined between BrS patients and controls. Control hiPSCs were differentiated into spontaneously contracting cardiac clusters...
December 2017: Stem Cell Research
https://www.readbyqxmd.com/read/29038108/ajmaline-induced-slowing-of-conduction-in-the-right-ventricular-outflow-tract-cannot-account-for-st-elevation-in-patients-with-type-i-brugada-ecg
#12
EDITORIAL
Charles Antzelevitch, Bence Patocskai
No abstract text is available yet for this article.
October 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29038102/st-elevation-magnitude-correlates-with-right-ventricular-outflow-tract-conduction-delay-in-type-i-brugada-ecg
#13
Kevin M W Leong, Fu Siong Ng, Cheng Yao, Caroline Roney, Patricia Taraborrelli, Nicholas W F Linton, Zachary I Whinnett, David C Lefroy, D Wyn Davies, Phang Boon Lim, Sian E Harding, Nicholas S Peters, Prapa Kanagaratnam, Amanda M Varnava
BACKGROUND: The substrate location and underlying electrophysiological mechanisms that contribute to the characteristic ECG pattern of Brugada syndrome (BrS) are still debated. Using noninvasive electrocardiographical imaging, we studied whole heart conduction and repolarization patterns during ajmaline challenge in BrS individuals. METHODS AND RESULTS: A total of 13 participants (mean age, 44±12 years; 8 men), 11 concealed patients with type I BrS and 2 healthy controls, underwent an ajmaline infusion with electrocardiographical imaging and ECG recordings...
October 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28948234/mechanisms-underlying-epicardial-radiofrequency-ablation-to-suppress-arrhythmogenesis-in-experimental-models-of-brugada-syndrome
#14
Bence Patocskai, Namsik Yoon, Charles Antzelevitch
OBJECTIVES: This study sought to test the hypothesis that elimination of sites of abnormal repolarization, via epicardial RFA, suppresses the electrocardiographic and arrhythmic manifestations of BrS. BACKGROUND: Brugada syndrome (BrS) is associated with ventricular tachycardia and ventricular fibrillation leading to sudden cardiac death. Nademanee et al. reported that radiofrequency ablation (RFA) of right ventricular outflow tract epicardium significantly reduced the electrocardiogram and arrhythmic manifestations of BrS...
April 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28877999/sudden-cardiac-arrest-while-eating-a-hot-dog-a-rare-presentation-of-brugada-syndrome-in-a-child
#15
Isa Ozyilmaz, Bedir Akyol, Yakup Ergul
Patients who are diagnosed with Brugada syndrome (BS) usually experience sudden cardiac arrest (SCA) and arrhythmia when they have a high fever, consume alcohol, and, more frequently, during their night sleep. In some rare cases, an SCA can be seen depending on a possible vagal stimulus, such as eating a large bite of food. We describe a 9-year-old patient who had a sudden cardiac attack while he was eating a large hot dog. After successful resuscitation, a suspicious ST elevation in V2 was seen in his electrocardiographic evaluation...
October 2017: Pediatrics
https://www.readbyqxmd.com/read/28781860/masquerading-bundle-branch-block-obscuring-the-diagnosis-of-brugada-syndrome-an-electrocardiographic-and-vectorcardiographic-study
#16
Isabel V Konopka, Hugo A Garro, Rita B Tepper, Norma Pizzarelli, Mario D Gonzalez, Rafael S Acunzo
We describe the induction of a masquerading bundle branch block in two patients with Brugada syndrome following the administration of Ajmaline. The development of this conduction disturbance prevented the correct electrocardiographic diagnosis. However, the simultaneously obtained vectocardiogram identified both the Brugada pattern and the masquerading bundle branch block.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28666944/sodium-channel-blocker-challenge-in-the-familial-screening-of-brugada-syndrome-safety-and-predictors-of-positivity
#17
Dylan Therasse, Frederic Sacher, Bertrand Petit, Dominique Babuty, Philippe Mabo, Raphael Martins, Laurence Jesel, Philippe Maury, Jean Luc Pasquie, Jacques Mansourati, Jean Marc Dupuis, Florence Kyndt, Aurélie Thollet, Beatrice Guyomarch, Julien Barc, Jean Jacques Schott, Herve Le Marec, Richard Redon, Vincent Probst, Jean-Baptiste Gourraud
BACKGROUND: Sodium-channel blocker challenge (SCBC) is frequently performed to unmask Brugada syndrome. OBJECTIVE: We aim to identify predictors of positivity and complications of SCBC in the setting of familial screening of Brugada syndrome. METHODS: All consecutive patients from 2000 to 2014 who benefit from a sodium-channel blocker and belong to a family with at least 2 subjects affected by the syndrome were enrolled and followed prospectively...
October 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28654178/dual-catalytic-activity-of-a-cytochrome-p450-controls-bifurcation-at-a-metabolic-branch-point-of-alkaloid-biosynthesis-in-rauwolfia-serpentina
#18
Thu-Thuy T Dang, Jakob Franke, Evangelos Tatsis, Sarah E O'Connor
Plants create tremendous chemical diversity from a single biosynthetic intermediate. In plant-derived ajmalan alkaloid pathways, the biosynthetic intermediate vomilenine can be transformed into the anti-arrhythmic compound ajmaline, or alternatively, can isomerize to form perakine, an alkaloid with a structurally distinct scaffold. Here we report the discovery and characterization of vinorine hydroxylase, a cytochrome P450 enzyme that hydroxylates vinorine to form vomilenine, which was found to exist as a mixture of rapidly interconverting epimers...
August 1, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/28521022/management-of-untreatable-ventricular-arrhythmias-during-pharmacologic-challenges-with-sodium-channel-blockers-for-suspected-brugada-syndrome
#19
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
#20
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
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