Evidence mapPaperPMID 40165484Full record

GuidelineEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025

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 ESC, the ESC Working Group on Cardiovascular Pharmacotherapy, the Association of European Paediatric and Congenital Cardiology (AEPC), the Paediatric & Congenital Electrophysiology Society (PACES), the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS).

Elijah R Behr, Bo Gregers Winkel, Bode Ensam, Alberto Alfie, Elena Arbelo, Colin Berry, Marina Cerrone, Giulio Conte, Lia Crotti, Cecilia M Gonzalez Corcia and 23 more

Abstract readConsensus StatementPractice Guideline
In one paragraph

Guideline in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed.

  1. Epicardial ablation in high-risk Brugada syndrome to prevent ventricular fibrillation: results from a randomized clinical trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Trial
  2. Brugada Syndrome: an exemplar for the genomic basis of sudden death.European journal of human genetics : EJHG · 2026
    Review
  3. Article
  4. Further mystification of SCN5A phenotypes: sodium channel blockade in individuals with loss-of-function sodium channel mutations dangerous or helpful?Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  5. Coronary artery spasm in cardiac arrest survivors.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Review
  6. Article
  7. Review
  8. Beyond the type 1 pattern: comprehensive risk stratification in Brugada syndrome.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
    Review
  9. Practical compendium of antiarrhythmic drugs: a clinical consensus statement of the European Heart Rhythm Association of the European Society of Cardiology.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Review
  10. Accumulating evidence for epicardial ablation in malignant forms of Brugada syndrome: summary of two randomized clinical trials.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Article
  11. Diagnosing Brugada syndrome: look for right ventricular outflow tract conduction delay.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Article
  12. Review
  13. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Elijah R BehrCardiovascular and Genomics Research Institute, School of Health and Medical Sciences, City St. George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.ORCID 0000-0002-8731-2853
Bo Gregers WinkelDepartment of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.ORCID 0000-0002-3063-4712
Bode EnsamCardiovascular and Genomics Research Institute, School of Health and Medical Sciences, City St. George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.ORCID 0000-0002-9655-8708
Alberto AlfieElectrophysiology Section, Cardiology Division, Hospital Nacional Profesor Alejandro Posadas, Moron, Argentina.ORCID 0000-0001-5967-4331
Elena ArbeloEuropean Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart.ORCID 0000-0003-0424-6393
Colin BerryDepartment of Cardiology, Golden Jubilee National Hospital, Glasgow, UK.ORCID 0000-0002-4547-8636
Marina CerroneThe Leon Charney Division of Cardiology, New York University Grossmann School of Medicine, New York, NY, USA.ORCID 0000-0002-6122-9939
Giulio ConteDivision of Cardiology, Cardiocentro Ticino Institute Ente Ospedaliero Cantonale, Lugano, Switzerland.ORCID 0000-0003-2248-3456
Lia CrottiIstituto Auxologico Italiano, IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Milan, Italy.ORCID 0000-0001-8739-6527
Cecilia M Gonzalez CorciaDepartment of Cardiology, Sainte-Justine University Hospital Center, Montreal, QC, Canada.
Juan Carlos KaskiCardiovascular and Genomics Research Institute, School of Health and Medical Sciences, City St. George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.ORCID 0000-0001-8068-0189
Koonlawee NademaneeDepartment of Medicine, Center of Excellence in Arrhythmia Research, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.ORCID 0000-0001-8139-0343
Pieter G PostemaEuropean Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart.ORCID 0000-0003-2863-9159
Silvia PrioriEuropean Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart.ORCID 0000-0001-6877-0288
Vincent ProbstEuropean Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart.ORCID 0000-0002-5492-8619
Georgia Sarquella-BrugadaEuropean Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart.ORCID 0000-0002-6857-8904
Eric Schulze-BahrEuropean Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart.ORCID 0000-0001-6884-2501
Rafik TadrosDepartment of Medicine, Montreal Heart Institute, Montreal, QC, Canada.ORCID 0000-0002-1472-0258
Arthur WildeEuropean Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart.ORCID 0000-0002-0528-0852
Jacob Tfelt-HansenDepartment of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.ORCID 0000-0003-3895-9316
Christian WolpertDepartment of Cardiology, Kliniken Ludwigsburg Bietigheim gGmbH, Ludwigsburg, Germany.
Alejandro CuestaServicio Electrofisiología, Unidad Académica Cardiología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay.
Peter DammanDepartment of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
Dobromir DobrevInstitute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, Essen, Germany.
Fabrizio DragoPaediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Kristina HaugaaDepartment of Cardiology, ProCardio Center for Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Andrew KrahnDivision of Cardiology, University of British Columbia, Vancouver, BC, Canada.
Ulrich KrauseDepartment of Pediatric Cardiology, University Medical Center Göttingen, Georg-August-University, Intensive Care Medicine and Neonatology, Göttingen, Germany.
Pier D LambiaseDept of Cardiology, Institute of Cardiovascular Science UCL, Barts Heart Centre, London, UK.
Carlo NapolitanoDepartment of Molecular Medicine, University of Pavia, Pavia, Italy.
Katja E OdeningDepartment of Cardiology and Department of Physiology, University Hospital Bern (Inselspital) and University of Bern, Bern, Switzerland.
Wataru ShimizuDepartment of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
Christian VeltmannHeart Center Bremen, Electrophysiology Bremen, Bremen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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.

Indexed as

Arrhythmias, CardiacCardiac ElectrophysiologyDeath, Sudden, CardiacElectrophysiologic Techniques, CardiacConsensusElectrocardiographyHumansPredictive Value of TestsacetylcholineadenosineajmalineBrugada syndromecardiac arrestcatecholaminergic polymorphic ventricular tachycardiacoronary vasospasmdrug challengeepinephrineergonovineflecainideisoproterenolpilsicainideprocainamideprovocation testingsodium channel blocker testsudden arrhythmic death syndromesudden cardiac deathWolff-Parkinson-White syndrome

Identifiers

PMID40165484
PMCPMC12018878

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.