{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T06:41:48Z","timestamp":1769582508476,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ajmaline challenge (AC) is used for diagnosing suspected Brugada syndrome (BS) in patients with unexplained syncope, survived cardiac arrest, or for family screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate baseline ECG markers predicting a positive AC in the absence of a spontaneous diagnostic Brugada ECG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Baseline ECGs of 221 consecutive patients undergoing AC (up to 1\u2009mg\/kg bodyweight) were analyzed. ECGs from positive and negative tests were compared, with Q\u2010, R\u2010, S\u2010, J\u2010, and T\u2010wave amplitudes and intervals measured in all 12 leads.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      221 patients underwent AC; the cohort was 71% male, and 7% had survived cardiac arrest. AC was positive in 93 patients (42%). Prominent S\u2010waves in lead II and J\u2010waves in V1 predicted a positive AC (S\u2010wave duration: 36 vs. 22\u2009ms,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01; J\u2010wave amplitude V1: 0.06 vs. 0.01\u2009mV,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). ROC analysis confirmed discriminative value for S\u2010wave duration in lead II (AUC 0.79) and J\u2010wave amplitude in V1 (AUC 0.71). A cut off of \u2265\u200919\u2009ms for S\u2010wave duration in lead II showed 96% sensitivity for a positive test (OR 17.3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). J\u2010wave amplitude in V1 \u2265\u20090.05\u2009mV was also significantly associated (OR 5.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients without a spontaneous diagnostic Brugada ECG, prominent S\u2010waves in lead II and J\u2010waves in V1 are subtle electrical abnormalities that help identify patients and family members with a higher likelihood of positive AC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anec.70137","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T08:46:16Z","timestamp":1765183576000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["ECG Markers of Positive Drug Challenge With Ajmaline in Patients With Brugada Syndrome"],"prefix":"10.1111","volume":"31","author":[{"given":"Erol","family":"T\u00fcl\u00fcmen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University  Mannheim Germany"},{"name":"Koc University Hospital  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathieu","family":"Kruska","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University  Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Wuerfel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University  Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Kohl","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University  Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Volker","family":"Liebe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University  Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1974-6147","authenticated-orcid":false,"given":"Ibrahim","family":"Akin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University  Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juergen","family":"Kuschyk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University  Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Duerschmied","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University  Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Borggrefe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University  Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2275-7149","authenticated-orcid":false,"given":"Boris","family":"Rudic","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiology, Angiology, Haemostaseology, and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim Heidelberg University  Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"665","article-title":"J\u2010Wave Syndromes Expert Consensus Conference Report: Emerging Concepts and Gaps in Knowledge","volume":"19","author":"Antzelevitch C.","year":"2017","journal-title":"Europace"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.04.017"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118392041"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.01.024"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.12.031"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux226"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2020.08.032"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000144299.17008.07"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.04.009"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01421-8"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.07.029"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13349"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.2174\/1573403X10666140514103612"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv316"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.887026"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.04.044"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13496"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001941"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.03.022"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.017885"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2017.04.005"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.05.099"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2020.618254"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvm090"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl205"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eup189"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2017.05.016"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.04.017"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad295"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2004.11.025"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac262"}],"container-title":["Annals of Noninvasive Electrocardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anec.70137","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/anec.70137","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anec.70137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T17:25:19Z","timestamp":1769534719000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/anec.70137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,8]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/anec.70137"],"URL":"https:\/\/doi.org\/10.1111\/anec.70137","archive":["Portico"],"relation":{},"ISSN":["1082-720X","1542-474X"],"issn-type":[{"value":"1082-720X","type":"print"},{"value":"1542-474X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,8]]},"assertion":[{"value":"2025-09-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70137"}}