Electrophysiologic characteristics and implications of induced ventricular fibrillation in symptomatic patients with Brugada syndrome
Electrophysiologic characteristics and implications of induced ventricular fibrillation in symptomatic patients with Brugada syndrome
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DOI：
10.1016/s0735-1097(02)01867-3
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发表时间：
2002-06-05
影响因子：
24
通讯作者：
Kamakura, S
中科院分区：
文献类型：
--
作者：
Kanda, M;Shimizu, W;Kamakura, S
本研究检查了与程序性心室刺激（PVS）诱导的心室颤动（VF）相关的心电图和电生理学特征，Brugada综合征的特征是右胸导联（V-1-V-3）ST段抬高和VF发作。四名有症状的Brugada综合征患者（33名男性和1名女性; 44 +/- 12岁）根据VF伴PVS的诱导分为两组：22例诱发VF的患者需要直接心脏复律终止（诱导VF组）和12例未诱导VF的患者结果诱发室颤组QRS波时限较长，右束分支传导阻滞发生率较高，信号平均心电图晚电位检出率较高，与非诱发VF组相比，在额外刺激时，His-心室间期更长，从RVOT到左心室的传导时间更长。但心脏事件复发率无显著差异两组之间（通过植入式心律转复除颤器和心源性猝死记录的V-F）（22例患者中的8例[36%] vs. 12例患者中的7例[58%]）（1至149个月不等;结论：我们的数据表明，PVS诱导的VF取决于去极化异常的严重程度，但不能预测有症状的Brugada综合征的心脏事件复发，表明去极化和复极化异常在VF的发展中是重要的。(C)2002年，美国心脏病学会基金会。
OBJECTIVES The study examined the electrocardiographic and electrophysiologic characteristics in relation to programmed ventricular stimulation (PVS)-induced ventricular fibrillation (VF), as well as the implications of PVS-induced VF on the recurrence of cardiac events in Symptomatic Brugada syndrome.BACKGROUND Brugada syndrome is characterized by ST-segment elevation in the right precordial leads (V-1-V-3) and an episode of VF.METHODS Thirty-four symptomatic patients with Brugada syndrome (33 men and I woman; 44 +/- 12 years old) were classified into two groups according to the inducibility of VF with PVS: 22 patients with induced VF requiring direct cardioversion for termination (Induced VF group) and 12 patients without induced VF (Noninduced VF group).RESULTS The induced VF group showed a longer QRS duration, a higher incidence of right bundle branch block and late potentials detected on the signal-averaged electrocardiogram, longer His-ventricular intervals and a longer conduction time from the RVOT to the left ventricle at extrastimulation than those in the non-induced VF group. However, there was no significant difference in the recurrence of cardiac events (V-F documented by an implantable cardioverter-defibrillator and sudden cardiac death) between the two groups (8 [36%] of 22 patients vs. 7 [58%] of 12 patients) during long-term follow-up (range 1 to 149 months; mean 38).CONCLUSIONS Our data suggest that induction of VF by PVS depends on the severity of depolarization abnormalities but does not predict the recurrence of cardiac events in symptomatic Brugada syndrome, indicating that both depolarization and repolarization abnormalities are important in the development of VF. (C) 2002 by the American College of Cardiology Foundation.