Brugada

[villy1]

My question is if i can buy Ajmaline to test Brugada syndrome on my daddy???

[villy1]

Hi ...well yeah they can"t wait any longer and are planning surgery next week!I know it's genetic and i prob.will go testing as well!I am 26 and female and the only child,however this happens pretty much to males...Thank you so much,i will keep my prayers to my daddy and hope everything will be okay!

[Dave2923]

    If they are already going with the ICD then an Ajmaline would be useless anyways. A positive Ajmaline test just results in the ICD going in and he is already getting that this week, so he's pretty much already all squared away. But I would definetely encourage you and other family members to be asking doctors about genetic testing. The most common Brugada gene is the SCN5A gene that encodes the sodium channel gating function. Most people with Brugada will have their cardiac arrest when vagal tone is high (so usually during sleep) and generally are male and in their 30's-40's, so anyone in your family who is a male in that age range should be a first testing priority right now. Hope your dad feels better!

[jrbon]

Remember that if your father has it, you and your sons should be tested for it.

Jesus

[villy1]

Hi Dave,thanks for your time....well the problem is that i live in USA and my dad lives in Bulgaria!His heart was out of rithm for a while and they tested him for a lots of things...what the results showed was that he had Brugada 80% sure but we don/t have Ajmaline in BG to make sure he has 100% positive test for Brugada syndrome ,so i was just wondering if there is any chance i can buy that Ajmaline from US and ship it to Bulgaria so they are 100% sure he has that!But anyways he is going to get defibrillator implanted next week,they can't wait any longer:(

[Dave2923]

    Well, first of all, what has you thinking that your dad might have Brugada Syndrome? Did a doctor tell him his EKG's look suspicious for the Brugada sign? If not, then I would definetely not jump to the conclusion that your father needs to be tested for this very rare electrical heart disease. If he is having general heart symptoms (i.e. palpitations, shortness of breath, or chest pain) there are a lot of other things a doctor will be looking at first. The only real exceptions would be a family history of Brugada Syndrome (confirmed by genetic testing and history of cardiac arrest in young family members) and/or his EKG showing something close to the Brugada sign.
       Ajmaline is considered the best sodium channel blocker to be used in a drug challenge test that may provoke the Brugada sign in patients where it may be "concealed" on a baseline EKG. However, it is unavailable in America, and a few other high populous countries as well. There are other sodium channel blockers, one I believe is called Flenicaine, which can be used for this test. You see, Brugada Syndrome is caused by a sodium ion channel problem where not enough sodium is allowed in. Therefore, administering a sodium channel blocker can further exacerbate a borderline Brugada EKG (as the Na+ concentration will be further reduced).
      If it turns out someone does have Brugada an ICD will most likely be offered. However, the ICD is simply there as a protective measure in case cardiac arrest occurs. Anti-arrhythmic treatment is most often seen with Quinidine, which is known to stabilize the synchronization of the ventricles (a common problem in Brugada, especially in the RV and even more specifically the RVOT) as well as some calcium channel blockers (due to the Na+/Ca2+ exchanger gene expression NCX1).
      Overall, if you have reason to suspect Brugada Syndrome you will need to consult an electrophysiologist.  

[ed34]

You should have a proper diagnosis by a professional because this illness is not good to leave untreated. In many cases patients receive an implanted defibrillator to put hearts back into rhythm if cardiac arrest seems likely.
I wouldn't just try different medications.