Effect of baroreflex stimulation using phenylephrine injection on ST segment elevation and ventricular arrhythmia-inducibility in Brugada syndrome patients

doi:10.1093/europace/eun365

Europace Advance Access originally published online on January 8, 2009
Europace 2009 11(3):382-384; doi:10.1093/europace/eun365

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Effect of baroreflex stimulation using phenylephrine injection on ST segment elevation and ventricular arrhythmia-inducibility in Brugada syndrome patients

Vincent Probst¹^,2^,3^,*, Philipe Mabo⁴, Frederic Sacher⁵, Dominique Babuty⁶, Jacques Mansourati⁷ and Hervé Le Marec¹^,2^,3

¹ INSERM, UMR915, Nantes F-44000, France; ² Université de Nantes, l’institut du Thorax, Nantes F-44000, France; ³ CHU Nantes, l’institut du Thorax, Service de Cardiologie, Nantes F-44000, France; ⁴ Departement de Cardiologie, Hôpital Pontchaillou, Rennes, France; ⁵ Service de Cardiologie, Hôpital Cardiologique du Haut Leveque, Bordeaux, France; ⁶ Service de Cardiologie B, Hôpital Trousseau, Tours, France; ⁷ Service de Cardiologie, Centre Hospitalo-Universitaire de Brest, Brest, France

Aims: Patients affected by Brugada syndrome (BrS) are at risk of suddencardiac death specifically at rest, when vagal tone is high.The aim of our study was to assess whether a phenylephrine injection,which provokes a baroreflex stimulation, could induce modificationof the ST segment elevation and ventricular arrhythmias.

Methods and results: Baroreflex test was performed with the administration of phenylephrine(2 µg/kg) to four highly symptomatic patients in a settingfully equipped for cardiac resuscitation. Phenylephrine injectioninduced a deep vagal stimulation with a decrease in the meanheart rate from 75 ± 7 to 50 ± 8 bpm and an increasein the mean systolic blood pressure from 141 ± 14 to204 ± 46 mmHg. ST segment elevation was not modifiedand no ventricular arrhythmias were induced during the test.

Conclusion: Although phenylephrine injection induced a major ${alpha}$ -adrenergicvasoconstriction followed by an arterial baroreflex, this testfailed to provoke ventricular arrhythmias or modification ofthe ST segment elevation in BrS patients.

^* Corresponding author: Service de cardiologie du CHU de Nantes, CHU de Nantes, Hôpital Nord, Bd Jacques Monod, 44093 Nantes Cedex, France. Tel: +33 2 16 50 08, Fax: +33 240165024, Email: vincent.probst{at}chu-nantes.fr

Manuscript submitted 6 September 2008. Accepted after revision 1 December 2008.

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