What to doStrength of evidence
An institutional SCB test protocol is advised to ensure appropriate organisational aspects and standardisation. This includes minimum safety requirements, location, lead placement, and criteria for when to stop test.graphic
It is advised that the testing location is always in-hospital and is adjusted in case of presumed higher risk for adverse events (e.g. testing in the cardiac catheterisation laboratory in the case of pre-existent AV conduction disturbances, presence of an SCN5A variant, etc.).graphic
Minimum safety requirements for an SCB test include as follows:
  • Suitably trained personnel.

  • 12-Lead ECG recording system.

  • Equipment to observe vital signs.

  • Basic and advanced life support and defibrillator on standby.

  • Availability of isoproterenol in case of arrhythmia.

graphic
It is advised that during the SCB test, ECG leads are recorded in higher right precordial positions (V1 and V2 in the second and/or third intercostal spaces).graphic
Ajmaline is preferred over flecainide when available for SCB testing.graphic
During the SCB test, acquisition of ECGs is advised to be continuous, or at least every 30–60 s, and the test terminated when stopping criteria are met.graphic
The criteria for stopping drug infusion during an SCB test are as follows:
  • Administration of the maximum dose according to body weight,

  • Type 1 Brugada ECG pattern,

  • QRS widening greater than 30% from baseline,

  • Ventricular arrhythmia more than isolated premature ventricular complexes,

  • Profound bradycardia or sinus arrest,

  • Type II second-degree or third-degree heart block, and/or

  • Allergic reaction.

graphic
What to doStrength of evidence
An institutional SCB test protocol is advised to ensure appropriate organisational aspects and standardisation. This includes minimum safety requirements, location, lead placement, and criteria for when to stop test.graphic
It is advised that the testing location is always in-hospital and is adjusted in case of presumed higher risk for adverse events (e.g. testing in the cardiac catheterisation laboratory in the case of pre-existent AV conduction disturbances, presence of an SCN5A variant, etc.).graphic
Minimum safety requirements for an SCB test include as follows:
  • Suitably trained personnel.

  • 12-Lead ECG recording system.

  • Equipment to observe vital signs.

  • Basic and advanced life support and defibrillator on standby.

  • Availability of isoproterenol in case of arrhythmia.

graphic
It is advised that during the SCB test, ECG leads are recorded in higher right precordial positions (V1 and V2 in the second and/or third intercostal spaces).graphic
Ajmaline is preferred over flecainide when available for SCB testing.graphic
During the SCB test, acquisition of ECGs is advised to be continuous, or at least every 30–60 s, and the test terminated when stopping criteria are met.graphic
The criteria for stopping drug infusion during an SCB test are as follows:
  • Administration of the maximum dose according to body weight,

  • Type 1 Brugada ECG pattern,

  • QRS widening greater than 30% from baseline,

  • Ventricular arrhythmia more than isolated premature ventricular complexes,

  • Profound bradycardia or sinus arrest,

  • Type II second-degree or third-degree heart block, and/or

  • Allergic reaction.

graphic
What to doStrength of evidence
An institutional SCB test protocol is advised to ensure appropriate organisational aspects and standardisation. This includes minimum safety requirements, location, lead placement, and criteria for when to stop test.graphic
It is advised that the testing location is always in-hospital and is adjusted in case of presumed higher risk for adverse events (e.g. testing in the cardiac catheterisation laboratory in the case of pre-existent AV conduction disturbances, presence of an SCN5A variant, etc.).graphic
Minimum safety requirements for an SCB test include as follows:
  • Suitably trained personnel.

  • 12-Lead ECG recording system.

  • Equipment to observe vital signs.

  • Basic and advanced life support and defibrillator on standby.

  • Availability of isoproterenol in case of arrhythmia.

graphic
It is advised that during the SCB test, ECG leads are recorded in higher right precordial positions (V1 and V2 in the second and/or third intercostal spaces).graphic
Ajmaline is preferred over flecainide when available for SCB testing.graphic
During the SCB test, acquisition of ECGs is advised to be continuous, or at least every 30–60 s, and the test terminated when stopping criteria are met.graphic
The criteria for stopping drug infusion during an SCB test are as follows:
  • Administration of the maximum dose according to body weight,

  • Type 1 Brugada ECG pattern,

  • QRS widening greater than 30% from baseline,

  • Ventricular arrhythmia more than isolated premature ventricular complexes,

  • Profound bradycardia or sinus arrest,

  • Type II second-degree or third-degree heart block, and/or

  • Allergic reaction.

graphic
What to doStrength of evidence
An institutional SCB test protocol is advised to ensure appropriate organisational aspects and standardisation. This includes minimum safety requirements, location, lead placement, and criteria for when to stop test.graphic
It is advised that the testing location is always in-hospital and is adjusted in case of presumed higher risk for adverse events (e.g. testing in the cardiac catheterisation laboratory in the case of pre-existent AV conduction disturbances, presence of an SCN5A variant, etc.).graphic
Minimum safety requirements for an SCB test include as follows:
  • Suitably trained personnel.

  • 12-Lead ECG recording system.

  • Equipment to observe vital signs.

  • Basic and advanced life support and defibrillator on standby.

  • Availability of isoproterenol in case of arrhythmia.

graphic
It is advised that during the SCB test, ECG leads are recorded in higher right precordial positions (V1 and V2 in the second and/or third intercostal spaces).graphic
Ajmaline is preferred over flecainide when available for SCB testing.graphic
During the SCB test, acquisition of ECGs is advised to be continuous, or at least every 30–60 s, and the test terminated when stopping criteria are met.graphic
The criteria for stopping drug infusion during an SCB test are as follows:
  • Administration of the maximum dose according to body weight,

  • Type 1 Brugada ECG pattern,

  • QRS widening greater than 30% from baseline,

  • Ventricular arrhythmia more than isolated premature ventricular complexes,

  • Profound bradycardia or sinus arrest,

  • Type II second-degree or third-degree heart block, and/or

  • Allergic reaction.

graphic
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