Ion channels disorders, such as Brugada Syndrome (BS), long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT) may account for at least one-third of the unexplained sudden cardiac deaths. Dental care in patients with cardiac channelopathies (CCh) is controversial and a challenge due to potential risk of life-threatening events. We assessed the hypothesis that the use of local dental anethesia with lidocaine with or without epinephrine can be safe, not resulting in life-threatening arrythymias (hemodinamically unstable arrhythmias or appropriate device shocks) in selected patients with CCh.Methods: Pilot randomized double-blind trial comparing the use of lidocaine 2% without vasoconstrictor and with 1:100,000 epinephrine in patients with CCh, under restorative dental treatment in two sessions, wash-out period of 7 days (cross-over trial). A 28h - Holter monitoring was performed in all patients. Specific records were also conducted in three time periods by 12-lead ECG, digital sphygmomanometer and an anxiety scale was applied. Exclusion and inclusion criteria were made to select these patients (ClinicalTrials.gov-ID: NCT03182777). Corrected QT interval, dynamic changes in right precordial leads in SB, ventricular/supraventricular arrhythmias frequency and device shocks were also analyzed.Results: Eighteen patients, mean age of 45±16,44 years; female (11/18; 61.1%), with CCh: 11 (61.1%) had BS, five (27.8%) had LQTS and two (11.1%) had CPVT; six (33.3%) of them had implantable defibrillator. Mean and maximum heart rate were increased after the use of epinephrine in the anesthesia period (65x68 bpm; p=0.015; 80x89 bpm; p=0.001). Blood pressure, electrocardiographic changes and anxiety measurement showed no statistically significant differences. Any life-threatening arrhythmias occurred during dental treatment, regardless the type of anesthesia. In conclusion, the use of local dental anesthesia with lidocaine, regardless of the use of vasoconstrictor, was considered safe in these selected patients with channelopathies. These preliminary findings need to be confirmed in a larger population study.