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)
EP Europace Journal
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.
Contributors
Elijah R Behr
Author
City St George's University of London London , United Kingdom of Great Britain & Northern Ireland
Bode Ensam
Author
Alberto Alfie
Author
Colin Berry
Author
University of Glasgow Glasgow , United Kingdom of Great Britain & Northern Ireland
Marina Cerrone
Author
New York University Langone Medical Center New York , United States of America
Lia Crotti
Author
Cecilia M Gonzalez Corcia
Author
Juan Carlos Kaski
Author
St George's Hospital (London) London , United Kingdom of Great Britain & Northern Ireland
Koonlawee Nademanee
Author
Vincent Probst
Author
Christian Wolpert
Author
Alejandro Cuesta
Author
Peter Damman
Author
Dobromir Dobrev
Author
Fabrizio Drago
Author
Kristina Haugaa
Author
Andrew Krahn
Author
Ulrich Krause
Author
Pier D Lambiase
Author
Carlo Napolitano
Author
Katja E Odening
Author
Wataru Shimizu
Author
Christian Veltmann
Author
