aVR sign as a risk factor for life-threatening arrhythmic events in patients with Brugada syndrome
aVR sign as a risk factor for life-threatening arrhythmic events in patients with Brugada syndrome
复制标题
DOI：
10.1016/j.hrthm.2007.04.017
复制
发表时间：
2007-08-01
期刊：
影响因子：
5.5
通讯作者：
Shahrzad, Shahab
中科院分区：
文献类型：
--
作者：
Bigi, Mohamad Ali Babai;Aslani, Amir;Shahrzad, Shahab
背景Brugada综合征（BS）的危险分层是有争议的，特别是在无症状的个体中。目的本研究的目的是评价aVR导联在BS患者中的意义。（24名男性，平均年龄32.1 +/- 13.6岁）和24名健康的年龄和性别匹配的controls.Results13例有症状。复发患者的aVR导联R波振幅或R/q比显著高于未复发患者。aVR征定义为aVR导联R波≥ 0.3mV或R/q ≥ 0.75。大多数复发（78%）发生在存在aVR体征的患者中; 84%存在aVR体征的BS患者在随访期间发生事件。相比之下，只有27%的无aVR体征的BS患者在随访期间发生事件。结论我们的研究表明，aVR导联中明显的R波（aVR体征）与BS中发生心律失常事件的风险之间存在显着相关性。在存在BS的情况下，aVR导联中的显著R波可能反映更多的右心室传导延迟，随后更多的电异质性，这反过来又是心律失常风险较高的原因。
BACKGROUND Risk stratification in Brugada syndrome (BS) is controversial, especially in asymptomatic individuals.OBJECTIVE The aim of this study was to evaluate the significance of lead aVR in patients with BS.METHODS Twenty-four patients with the electrocardiogram pattern of BS (24 mate, mean age 32.1 +/- 13.6 years) and 24 healthy age- and gender-matched controls were studied.RESULTS Thirteen patients were symptomatic. The R-wave amplitude or R/q ratio in lead aVR was significantly greater in patients experiencing a recurrence compared with those who did not. The aVR sign was defined as R wave >= 0.3 mV or R/q >= 0.75 in lead aVR. Most of the recurrences (78%) were in patients with presentaVR sign; 84% of BS patients with present aVR sign had events during follow-up. In contrast, only 27% of BS patients with absent aVR sign had events during follow-up.CONCLUSION Our study shows significant correlation between a prominent R wave in lead aVR (aVR sign) and risk for development of arrhythmic events in BS. In the presence of BS, prominent R wave in lead aVR may reflect more right ventricular conduction delay and subsequently more electrical heterogeneity, which in turn is responsible for a higher risk of arrhythmia.