The diagnostic role of pharmacological provocation testing in cardiac electrophysiology: a clinical consensus statement of the European Heart Rhythm Association and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the
The pharmacological provocation test is a pivotal tool in cardiac electrophysiology for the diagnosis of potential causes of sudden cardiac death, sudden cardiac arrest (SCA), arrhythmias, symptoms, or ECG abnormalities. The 2022 European Society of Cardiology Guidelines for the Treatment of Ventricular Arrhythmias and Prevention of Sudden Cardiac Death offered guidance on provocation testing but did not describe the indications and requirements in depth. This clinical consensus statement, led by the European Heart Rhythm Association and approved by major international stakeholders, aims to advise the general cardiologist and the arrhythmia expert who to test and when, where, and how to do it. The statement focuses on current practice for the diagnosis of subclinical arrhythmia syndromes and the causes of SCA, building upon the recommendations of the Guidelines. We address the sodium channel blocker provocation test for patients suspected of Brugada syndrome as well as the use of epinephrine, isoproterenol, adenosine, ergonovine, and acetylcholine.
Authors
- Vincent Probst (ORCID: https://orcid.org/0000-0002-5492-8619)
- Arthur A.M. Wilde (ORCID: https://orcid.org/0000-0002-0528-0852)
- Georgia Sarquella‐Brugada (ORCID: https://orcid.org/0000-0002-6857-8904)
- Silvia Giuliana Priori (ORCID: https://orcid.org/0000-0001-6877-0288)
- Bode Ensam (ORCID: https://orcid.org/0000-0002-9655-8708)
- Elijah R. Behr (ORCID: https://orcid.org/0000-0002-8731-2853)
- M. Cecilia Gonzalez Corcia (ORCID: https://orcid.org/0000-0002-4289-049X)
- Lia Crotti (ORCID: https://orcid.org/0000-0001-8739-6527)
- Pieter G. Postema (ORCID: https://orcid.org/0000-0003-2863-9159)
- Rafik Tadros (ORCID: https://orcid.org/0000-0002-1472-0258)
- Alberto Alfie (ORCID: https://orcid.org/0000-0001-5967-4331)
- Marina Cerrone (ORCID: https://orcid.org/0000-0002-6122-9939)
- Giulio Conte (ORCID: https://orcid.org/0000-0003-2248-3456)
- Colin Berry (ORCID: https://orcid.org/0000-0002-4547-8636)
- Bo Gregers Winkel (ORCID: https://orcid.org/0000-0002-3063-4712)
- Eric Schulze‐Bahr (ORCID: https://orcid.org/0000-0001-6884-2501)
- Juan Carlos Kaski (ORCID: https://orcid.org/0000-0001-8068-0189)
- Koonlawee Nademanee (ORCID: https://orcid.org/0000-0001-8139-0343)
- Elena Arbelo (ORCID: https://orcid.org/0000-0003-0424-6393)
- Jacob Tfelt‐Hansen (ORCID: https://orcid.org/0000-0003-3895-9316)
Institutions
- University of Copenhagen (DK)
- Oslo University Hospital (NO)
- Centre National de la Recherche Scientifique (FR)
- Hospital Sant Joan de Déu Barcelona (ES)
- University Hospitals Birmingham NHS Foundation Trust (GB)
- University of British Columbia (CA)
- Radboud University Nijmegen (NL)
- Inserm (FR)
- Chulalongkorn University (TH)
- St George's, University of London (GB)
- Universidad de la República de Uruguay (UY)
- Baylor College of Medicine (US)
- University of Oslo (NO)
- University of Pavia (IT)
- Queen Elizabeth Hospital Birmingham (GB)
- Montreal Heart Institute (CA)
- University Hospital of Bern (CH)
- London Clinic (GB)
- St George’s University Hospitals NHS Foundation Trust (GB)
- Golden Jubilee National Hospital (GB)
- Centre Hospitalier Universitaire Sainte-Justine (CA)
- Copenhagen University Hospital (DK)
- Rigshospitalet (DK)
- University Medical Center (US)
- Radboud University Medical Center (NL)
- British Heart Foundation (GB)
- Istituti Clinici Scientifici Maugeri (IT)
- New Tokyo Hospital (JP)
- Centro de Investigación en Red en Enfermedades Cardiovasculares (ES)
- Ente Ospedaliero Cantonale (CH)
- University Hospital Münster (DE)
- Centro de Investigación Biomédica en Red (ES)
- Hospital Clínic de Barcelona (ES)
- Bambino Gesù Children's Hospital (IT)
- Mayo Clinic Health System (US)
- IRCCS Istituto Auxologico Italiano (IT)
- ERN GUARD-Heart (NL)
- Genomics England (GB)
- Klinikum Ludwigsburg (DE)
- Institut du Thorax (FR)
- Hospital Posadas (AR)
- Mayo Clinic in Florida (US)
- Amsterdam University Medical Centers (NL)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- Hospital de Clínicas (UY)
- Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES)
- West German Heart and Vascular Center Essen (DE)
- University College London (GB)
- New York University (US)
- University of Milano-Bicocca (IT)
- Universitat de Barcelona (ES)
- University of Göttingen (DE)
- Nippon Medical School (JP)
- University of Amsterdam (NL)
- Nantes Université (FR)
Publication Details
- Journal
- EP Europace
- Published
- 2025-03-28
- DOI
- https://doi.org/10.1093/europace/euaf067
- Citations
- 19
- Primary Topic
- Cardiac Arrhythmias and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 26.38