title: Different effect of the pure Na+ channel-blocker pilsicainide on the ST-segment response in the right precordial leads in patients with normal left ventricular function.
abstract: BACKGROUND
  The response of the ST-segment in the right precordial leads to Na+ channel blockers in patients without structural heart disease and a typical Brugada-type ECG has not been fully elucidated.
  
  
  RESULTS
  A pilsicainide challenge test was performed in 161 patients and according to recently established ECG criteria and an organized computer algorithm, the ST morphology was classified and the maximum increase in the J wave amplitude (maxDeltaJ) from the standard and high right precordial leads V1-3 was examined. Before the test, subjects exhibiting type 1 ECG in the standard leads were excluded. After administering pilsicainide, type 1 ECGs in the standard leads were observed in 31 cases and a maxDeltaJ of >or=200 microV was observed in 29 cases (23 type 1, 2 type 2/3 and 4 normal ECGs). In the additional higher right precordial leads, type 1 ECGs were observed in 55 cases and a maxDeltaJ of >or=200 microV was observed in 45 cases (42 type 1 and 3 type 2/3 ECGs).
  
  
  CONCLUSIONS
  A maxDeltaJ>or=200 microV induced by pilsicainide, including that measured in the high right precordial leads, was associated with a change mainly to a type 1 ECG.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medical Bioregulation, Yamaguchi University Graduate School of Medicine, Hofu, Japan. ueyama@yamaguchi-u.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ueyama
authors.forename: Akihiko
authors.initials: A
authors.lastname: Shimizu
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamagata
authors.forename: Masahiro
authors.initials: M
authors.lastname: Esato
authors.forename: Masato
authors.initials: M
authors.lastname: Ohmura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yoshiga
authors.forename: Masashi
authors.initials: M
authors.lastname: Kanemoto
authors.forename: Ryousuke
authors.initials: R
authors.lastname: Kametani
authors.forename: Akira
authors.initials: A
authors.lastname: Sawa
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Suzuki
authors.forename: Naoki
authors.initials: N
authors.lastname: Sugi
authors.forename: Masunori
authors.initials: M
authors.lastname: Matsuzaki
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D053840:Brugada Syndrome / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000473:pathology; D006801:Humans; D008012:Lidocaine / Q000031:analogs & derivatives* / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D026941:Sodium Channel Blockers / Q000494:pharmacology*; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology
chemical_list: D026941:Sodium Channel Blockers; D008012:Lidocaine; C042288:pilsicainide