Language
English
Publication Date
3-28-2025
Journal
EP Europace
DOI
10.1093/europace/euaf067
PMID
40165484
PMCID
PMC12018878
PubMedCentral® Posted Date
4-1-2025
PubMedCentral® Full Text Version
Post-print
Abstract
The pharmacological provocation test is a pivotal tool in cardiac electrophysiology for the diagnosis of potential causes of sudden cardiac death, sudden cardiac arrest (SCA), arrhythmias, symptoms, or ECG abnormalities. The 2022 European Society of Cardiology Guidelines for the Treatment of Ventricular Arrhythmias and Prevention of Sudden Cardiac Death offered guidance on provocation testing but did not describe the indications and requirements in depth. This clinical consensus statement, led by the European Heart Rhythm Association and approved by major international stakeholders, aims to advise the general cardiologist and the arrhythmia expert who to test and when, where, and how to do it. The statement focuses on current practice for the diagnosis of subclinical arrhythmia syndromes and the causes of SCA, building upon the recommendations of the Guidelines. We address the sodium channel blocker provocation test for patients suspected of Brugada syndrome as well as the use of epinephrine, isoproterenol, adenosine, ergonovine, and acetylcholine.
Keywords
Humans, Arrhythmias, Cardiac, Cardiac Electrophysiology, Consensus, Death, Sudden, Cardiac, Electrocardiography, Electrophysiologic Techniques, Cardiac, Predictive Value of Tests, drug challenge, provocation testing, sodium channel blocker test, ajmaline, flecainide, procainamide, pilsicainide, epinephrine, isoproterenol, adenosine, ergonovine, acetylcholine, sudden cardiac death, cardiac arrest, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, Wolff-Parkinson-White syndrome, coronary vasospasm, sudden arrhythmic death syndrome
Published Open-Access
yes
Recommended Citation
Behr, Elijah R; Winkel, Bo Gregers; Ensam, Bode; et al., "The Diagnostic Role of Pharmacological Provocation Testing in Cardiac Electrophysiology: A Clinical Consensus Statement of the European Heart Rhythm Association and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the Esc, the Esc Working Group on Cardiovascular Pharmacotherapy, the Association of European Paediatric and Congenital Cardiology (AEPC), the Paediatric & Congenital Electrophysiology Society (PACES), the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS)" (2025). Faculty and Staff Publications. 5424.
https://digitalcommons.library.tmc.edu/baylor_docs/5424