2017
DOI: 10.1016/j.hrcr.2016.11.006
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Proarrhythmogenic effects of lamotrigine during ajmaline testing for Brugada syndrome

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Cited by 8 publications
(3 citation statements)
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“…29 This is illustrated by a case report in which a 60-year-old woman using lamotrigine and levetiracetam was undergoing an ajmaline sodium channel blockade test as part of the diagnostic procedure for Brugada syndrome. 30 During ST elevation testing, QRS broadening and the development of bigeminy were observed. The ECG normalized after the ajmaline testing was stopped, and a repeat test off lamotrigine showed a type 1 Brugada pattern with no QRS broadening or electrical alternans.…”
Section: Discussionmentioning
confidence: 99%
“…29 This is illustrated by a case report in which a 60-year-old woman using lamotrigine and levetiracetam was undergoing an ajmaline sodium channel blockade test as part of the diagnostic procedure for Brugada syndrome. 30 During ST elevation testing, QRS broadening and the development of bigeminy were observed. The ECG normalized after the ajmaline testing was stopped, and a repeat test off lamotrigine showed a type 1 Brugada pattern with no QRS broadening or electrical alternans.…”
Section: Discussionmentioning
confidence: 99%
“…This hypothesis is further supported by patients with gastrointestinal disease harboring the SCN5A mutation expressing variable symptoms within each age group (34). Furthermore, Leong et al highlight a case of a patient harboring an SCN5A mutation with temporal lobe epilepsy and BrS (16). Animal studies in rats demonstrate the expression of SCN5A genes within the limbic system, suggesting that it can alter neuronal action potential propagation (35).…”
Section: Discussionmentioning
confidence: 96%
“…Whether LTG also blocks the cardiac sodium current (I Na ) at therapeutic doses (100–500 mg/day) yielding an effective plasma concentration between 2–16 µg/mL (7.8–62.5 µmol/L) [ 8 , 9 , 10 ], is unknown. However, clinical observations of Brugada syndrome (BrS) phenotype [ 11 , 12 , 13 , 14 ] and QRS prolongation [ 15 ] on the electrocardiograms (ECG) of epileptic patients treated with LTG are consistent with conduction disturbances and I Na block. Those observations, coupled with a series of case reports on LTG cardiotoxicity [ 16 , 17 , 18 ], prompted the FDA to restrict the use of LTG in 2021 and to add a warning label stating that “ Lamictal exhibits class 1B antiarrhythmic activity at therapeutically relevant concentrations.…”
Section: Introductionmentioning
confidence: 99%