Ajmaline Infusion for Unmasking Short-Coupled Purkinje Ectopy: Need for Speed?
Recent reports have spotlighted the potential of pharmacological tests with sodium channel blockers (SCB) in unmasking short-coupled premature ventricular contractions (ScPVCs), most frequently of Purkinje origin, in patients at risk for sudden cardiac death (SCD).1,2 While these studies were based on a rapid infusion protocol with ajmaline (1 mg/kg infused over 5-10 minutes2 or 1mg/kg infused over 10 minutes1), a stepwise dosing protocol has been shown to reduce the risk of serious arrhythmic events while maintaining diagnostic performance.
