Provocation Tests

Cardiac provocation tests are used when other diagnostic tests, such as electrocardiograms or Holter monitors, have not provided a definitive diagnosis or when more information is needed to determine the appropriate course of treatment for a patient with a cardiac condition.
Fig 49 provocation
Cardiac provocation tests, such as Ajmaline or Adrenaline provocation tests, are diagnostic tests used to assess the risk of developing life-threatening heart rhythm abnormalities, particularly in people with suspected inherited sudden cardiac death syndromes such as Brugada syndrome, Long QT syndrome or CPVT.
The provocation test involves administering certain drugs, which temporarily alters the heart’s electrical activity. During the test, an electrocardiogram (ECG) is continuously monitored to detect any changes in the heart’s electrical activity that would allow confirming the diagnosis.
The test is performed in a hospital setting, and the patient is monitored closely throughout the procedure. The test is considered safe but may be associated with some rare risks, such as an allergic reaction to the medication or the development of dangerous heart rhythms. Hence the need for this to be done by a qualified electrophysiologist.

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