Brugada Syndrome Clinical Trial
Official title:
Diagnostic Value and Safety of Flecainide Infusion Test in Brugada Syndrome
The study aims to use flecainide infusion test as diagnostic test to unmask concealed Brugada Syndrome cases. It proposes to assess the safety profile of this test in US patients and its higher sensitivity when compared to procainamide infusion (the conventional drug used in the USA). As a substudy it proposes to apply this test to early ARVC cases in order to evaluate if ECG changes similar to those seen in Brugada Syndrome could be unmasked by flecainide iv.
Brugada Syndrome is an inherited arrhythmogenic disease responsible for life-threatening
arrhythmias and sudden cardiac death in young individuals with structural normal heart.
It is characterized by a peculiar ECG pattern, but this pattern could be intermittent. The
infusion of sodium channel blockers (flecainide, ajmaline, procainamide) is used to unmask a
concealed ECG pattern, thus providing an essential contribution to the diagnosis of this
condition.
In the current clinical practice in USA, only procainamide is used for diagnostic purposes;
however in Europe only ajmaline and flecainide, available as iv formulations, are widely
used. European and Japanese studies have demonstrated that the use of flecainide harbors less
risks of adverse events in patients and may have a higher accuracy in unraveling the presence
of the disease.
In the present study the investigators propose to use flecainide infusion test in the
Cardiovascular Genetics Program at NYUMC, in order to assess its sensitivity and specificity
in diagnosing the disease and compare the incidence of adverse events to that observed during
procainamide use.
Additionally, the investigators propose to extend the study protocol to patients with a
suspect diagnosis of Arrhythmogenic Right Ventricular Tachycardia (ARVC), due to the possible
overlap between the two conditions.
The study has the following aims:
1. To demonstrate the higher sensitivity and specificity of flecainide iv infusion compared
to procainamide infusion for the diagnosis of Brugada Syndrome.
2. To demonstrate that flecainide is equally safe or safer than procainamide to use for
diagnosing Brugada Syndrome.
3. To demonstrate that flecainide has high sensitivity and specificity in diagnosing also
some patients with early stage Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC).
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