In patients with suspected Brugada syndrome, simple ECG criteria can enable discrimination between incomplete RBBB and types 2 and 3 Brugada patterns.

Using an isolated non‐working rat heart model, this study investigated the mechanisms of pharmacological pre‐conditioning (PC) induced by P2Y receptor stimulation with pyridoxal‐5′‐phosphate (PLP). After 6‐hydroxydopamine pretreatment and a 15‐min stabilization period, isolated rat hearts were perfused for 25 min then subjected to 40 min of global ischemia and 30 min of reperfusion (I/R); exposed for 15 min to 0.05 μm PLP bracketed for 25 min with broad‐spectrum P2 antagonists (suramin or PPADS) or with more specific P2Y antagonists (AMPαS or MRS2578), 1 μm each, followed by a 5‐min PLP‐free perfusion before I/R; treated during 25 min with either glybenclamide (GLY, 1 μm), 5‐hydroxydecanoic acid (5‐HD, 100 μm), U73122 (0.5 μm), H89 (1 μm), or KN93 (1 μm), with an infusion starting 5 min before PLP. The main endpoints were the rate–pressure product (RPP), creatine kinase (CK) release and area necrosis. Recovery of RPP, measured 5 min after reperfusion, was rapidly improved by PLP, blocked by the P2 antagonists, and decreased with the different inhibitors. Fifteen minutes after the end of ischemia, CK release reached maximal values in all groups. PLP provided significant protection, whereas the P2 antagonists, 5‐HD, a mitochondrial selective KATP antagonist and GLY a non‐selective KATP channel blocker, suppressed the protective effect on myocardial injury. The suppression of the cardioprotective effects of PLP by AMPαS, the PKA inhibitor (H89), and phospholipase C blocker (U73122) is in agreement with the P2Y11 receptor as a receptor for PLP‐induced PC. The suppression of the cardioprotective effects of PLP by MRS2578 and U73122 is in agreement with the P2Y6 receptor as a receptor for PLP‐induced PC. Pre‐ischemic exposure to nanomolar concentrations of PLP is protective against I/R. P2Y11 and P2Y6 represents the most likely candidate receptors for PLP‐induced cardiac PC.

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