Evidence map›Paper›PMID 41355478›Full record

ArticleAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2026

ECG Markers of Positive Drug Challenge With Ajmaline in Patients With Brugada Syndrome.

Erol Tülümen, Mathieu Kruska, Sara Wuerfel, Maximilian Kohl, Volker Liebe, Ibrahim Akin, Juergen Kuschyk, Daniel Duerschmied, Martin Borggrefe, Boris Rudic

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Article in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Erol TülümenDepartment of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Mathieu KruskaDepartment of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Sara WuerfelDepartment of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Maximilian KohlDepartment of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Volker LiebeDepartment of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Ibrahim AkinDepartment of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.ORCID 0000-0003-1974-6147
Juergen KuschykDepartment of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Daniel DuerschmiedDepartment of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Martin BorggrefeDepartment of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Boris RudicDepartment of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.ORCID 0000-0002-2275-7149

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAjmaline challenge (AC) is used for diagnosing suspected Brugada syndrome (BS) in patients with unexplained syncope, survived cardiac arrest, or for family screening. PURPOSE: To evaluate baseline ECG markers predicting a positive AC in the absence of a spontaneous diagnostic Brugada ECG.

methodsBaseline ECGs of 221 consecutive patients undergoing AC (up to 1 mg/kg bodyweight) were analyzed. ECGs from positive and negative tests were compared, with Q-, R-, S-, J-, and T-wave amplitudes and intervals measured in all 12 leads.

results221 patients underwent AC; the cohort was 71% male, and 7% had survived cardiac arrest. AC was positive in 93 patients (42%). Prominent S-waves in lead II and J-waves in V1 predicted a positive AC (S-wave duration: 36 vs. 22 ms, p < 0.01; J-wave amplitude V1: 0.06 vs. 0.01 mV, p < 0.001). ROC analysis confirmed discriminative value for S-wave duration in lead II (AUC 0.79) and J-wave amplitude in V1 (AUC 0.71). A cut off of ≥ 19 ms for S-wave duration in lead II showed 96% sensitivity for a positive test (OR 17.3, p < 0.001). J-wave amplitude in V1 ≥ 0.05 mV was also significantly associated (OR 5.4, p < 0.001).

conclusionIn patients without a spontaneous diagnostic Brugada ECG, prominent S-waves in lead II and J-waves in V1 are subtle electrical abnormalities that help identify patients and family members with a higher likelihood of positive AC.

Indexed as

AjmalineAnti-Arrhythmia AgentsBrugada SyndromeElectrocardiographyAdultBiomarkersFemaleHumansMaleMiddle AgedRetrospective StudiesVentricular FibrillationYoung AdultAjmalineAnti-Arrhythmia AgentsBiomarkersajmaline challengeBrugada syndromeECG markersprovocation testing

Identifiers

PMID41355478
PMCPMC12683172

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.