{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:43:38Z","timestamp":1792176218742,"version":"4.4.0"},"reference-count":128,"publisher":"Oxford University Press (OUP)","issue":"27","license":[{"start":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T00:00:00Z","timestamp":1687392000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007478","name":"Netherlands Cardiovascular Research Initiative","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002784","name":"Canada Research Chairs program","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002784","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The diagnosis of Brugada syndrome (BrS) requires the presence of a coved (Type 1) ST segment elevation in the right precordial leads of the electrocardiogram (ECG). The dynamic nature of the ECG is well known, and in patients with suspected BrS but non-diagnostic ECG at baseline, a sodium channel blocker test (SCBT) is routinely used to unmask BrS. There is little doubt, however, that in asymptomatic patients, a drug-induced Brugada pattern is associated with a much better prognosis compared to a spontaneous Type 1 ECG. The SCBT is also increasingly used to delineate the arrhythmogenic substrate during ablation studies. In the absence of a \u201cgold standard\u201d for the diagnosis of BrS, sensitivity and specificity of the SCBT remain elusive. By studying patient groups with different underlying diseases, it has become clear that the specificity of the test may not be optimal. This review aims to discuss the pitfalls of the SCBT and provides some directions in whom and when to perform the test. It is concluded that because of the debated specificity and the overall very low risk for future events in asymptomatic individuals, patients should be properly selected and counseled before SCBT is performed and that SCBT should not be performed in asymptomatic patients with a Type 2 Brugada pattern and no family history of BrS or sudden death.<\/jats:p>","DOI":"10.1093\/eurheartj\/ehad295","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T14:13:21Z","timestamp":1687616001000},"page":"2427-2439","source":"Crossref","is-referenced-by-count":36,"title":["Use, misuse, and pitfalls of the drug challenge test in the diagnosis of the Brugada syndrome"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0528-0852","authenticated-orcid":false,"given":"Arthur A M","family":"Wilde","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam , Room B2-256, Meibergdreef 9, Amsterdam 1105 AZ , The Netherlands"},{"name":"European Reference Network for rare, low-prevalence, or complex diseases of the heart (ERN GUARD-Heart) , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad S","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam , Room B2-256, Meibergdreef 9, Amsterdam 1105 AZ , The Netherlands"},{"name":"European Reference Network for rare, low-prevalence, or complex diseases of the heart (ERN GUARD-Heart) , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6419-1246","authenticated-orcid":false,"given":"Hiroshi","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama , Japan"},{"name":"Department of Cardiovascular Therapeutics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1472-0258","authenticated-orcid":false,"given":"Rafik","family":"Tadros","sequence":"additional","affiliation":[{"name":"Cardiovascular Genetics Center, Montreal Heart Institute, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al , Montreal, Qu\u00e9bec , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,6,22]]},"reference":[{"key":"2023120716425940300_ehad295-B1","doi-asserted-by":"crossref","first-page":"e295","DOI":"10.1016\/j.hrthm.2016.05.024","article-title":"J-Wave syndromes, expert consensus conference report: emerging concepts and gaps in 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