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Vol. 65. Issue 4.
Pages 393 (April 2012)
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Vol. 65. Issue 4.
Pages 393 (April 2012)
DOI: 10.1016/j.rec.2012.02.002
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Ajmaline Test and ESC 2010 Clinical Practice Guidelines on Atrial Fibrillation. Response
Test de ajmalina y guía de práctica clínica sobre fibrilación auricular 2010 de la ESC. Respuesta
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Manuel Anguitaa,
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manuelp.anguita.sspa@juntadeandalucia.es

Corresponding author: manuelp.anguita.sspa@juntadeandalucia.es
, Fernando Wornera
a Coordinadores del Grupo de Trabajo sobre Guías de Fibrilación Auricular, Comité de Guías de Práctica Clínica, Sociedad Española de Cardiología, Madrid, Spain
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To the Editor,

We read with interest the comments on our recent review of the European Society of Cardiology (ESC) 2010 guidelines for the management of atrial fibrillation (AF).1 As the authors of the letter point out, there have been several reports of Brugada syndrome being unmasked when class IC antiarrhythmic drugs (flecainide, propafenone) are used to treat AF. However, the proportion of cases detected in such circumstances is not high. From a total of 613 patients, we identified 11 patients with Brugada syndrome (1.8% of all cases with AF), while Pappone et al.2 diagnosed the syndrome in 11 (3%) of 356 cases of new-onset AF. That is presumably why the ESC guidelines did not make any recommendations on this aspect of the condition, and why we did not do so in our article. However, we agree with the authors that a diagnosis of Brugada syndrome leads to a need for specific treatment alternatives, and that clinicians should be alert to the emergence of typical electrocardiographic changes when treating AF patients with class IC antiarrhythmic drugs.

.

Corresponding author: manuelp.anguita.sspa@juntadeandalucia.es

Bibliography
[1]
Anguita M, Worner F, Domenech P, Marín F, Ortigosa J, Pérez-Villacastín J, et al..
Nuevas evidencias, nuevas controversias: análisis crítico de la guía de práctica clínica sobre fibrilación auricular 2010 de la Sociedad Europea de Cardiología..
Rev Esp Cardiol. , 65 (2012), pp. 7-13
[2]
Pappone C, Radinovic A, Manguso F, Vicedomini G, Sala S, Sacco FM, et al..
New onset atrial fibrillation asa first clinical manifestation of latent Brugada syndrome: prevalence and clinical significance..
Eur Heart J. , 30 (2009), pp. 2985-2992
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Revista Española de Cardiología (English Edition)

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