Discharge advice for patients following an Ajmaline test to find out if you have Brugada syndrome

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What is this information about?

This information is about what to expect after you have had an Ajmaline test to see if you have Brugada syndrome. It includes a list of side effects to look out for after you have the Ajmaline test, and next steps if you are diagnosed with Brugada syndrome.

What is Brugada syndrome?

Brugada syndrome is a rare inherited condition causing electrical abnormality in the heart (problems with your heart’s rhythm). This may or may not be seen on an ECG (electrocardiogram), which is a test where the electrical activity of the heart is recorded.  

Signs and symptoms of Brugada syndrome include: 

• fainting (syncope) 
• irregular fast heart rhythm  
• rarely, cardiac arrest. 

If we suspect you have Brugada but it is not showing on your ECG we will offer you an  Ajmaline test to help the diagnosis.  

Ajmaline is a medicine that works by showing up electrical abnormality caused by Brugada on an ECG.  

What happened during this procedure?

You were given a medicine called Ajmaline by infusion to find out if you have Brugada syndrome.  

Your heart tracings (ECGs) were recorded every two minutes to observe the changes in electrical activity in your heart each time you were given a small dose of Ajmaline. 

Once the test was completed you were monitored as you recovered from the procedure.  

You may also have had a cardioversion (‘shock treatment’) if your heart went very fast, to correct the heart rhythm. 

Will I have any discomfort?

During the test, you may have had: 

• a metallic taste in your mouth 
• visual disturbance 
• hot flushes  
• tingling skin  

These should have passed once the infusion is completed. 

After the test, you may notice: 

• diarrhoea (loose or runny poo) 
• loss of appetite 
• nausea and vomiting (feeling and being sick). 

These symptoms are normally managed at home but if you feel unwell or your symptoms last for longer than a few days please contact your GP or call 111 for advice. 

If you had a cardioversion, you would have been given a short-acting general anesthetic (be put to sleep). Your skin may be sore for a few days where the pads were applied. Taking Paracetamol or putting hydrocortisone cream on the sore area may help with these symptoms.

What should I do if I am diagnosed with Brugada syndrome?

If you are diagnosed with Brugada syndrome, you may be advised to avoid:

• exposure to extreme temperatures (being too hot or too cold) 
• dehydration (not drinking enough) 
• excessive alcohol consumption 
• high intensity exercise  
• certain medication.  

Your cardiologist (heart doctor) may suggest you have an ICD (implantable cardioverter defibrillator) fitted to manage your condition.  

For more information on Brugada syndrome, go to Brugada Syndrome – Arrhythmia Alliance – UK 

If you are told that you have Brugada syndrome and would like some support, please contact our arrhythmia nurses. Their contact details are below. 

Should I limit my activities after the Ajmaline test?

There are no activities to avoid after the test.  

If you also had a cardioversion, you should not operate machinery, drive or sign a legal document for the next 24 hours, as you had a short general anaesthetic. 

When can I drive again after the Ajmaline test?

There is no restriction for driving after an Ajmaline test.  

If you are told you have Brugada syndrome you must tell the DVLA. You must not drive if you have suffered from either a loss of consciousness or fainting or had a cardiac arrest. Look at  www.gov.uk/brugada-driving for more information. 

Check with your cardiologist before you leave the hospital. 

What happens next?

A detailed report will be sent to your GP.  

If your Ajmaline test showed that you have Brugada syndrome, you will be seen again in the outpatient clinic. An appointment will be sent to you. 

Contact details for Cardiac Care Unit

For more general concerns, please contact your GP, or if it is an urgent health issue contact 111 for advice or 999 for help.