Relationship between dominant prolongation of the filtered QRS duration in the right precordial leads and clinical characteristics in Brugada syndrome
Relationship between dominant prolongation of the filtered QRS duration in the right precordial leads and clinical characteristics in Brugada syndrome
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DOI：
10.1111/j.1540-8167.2005.00262.x
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发表时间：
2005-12-01
影响因子：
2.7
通讯作者：
Aizawa, Y
中科院分区：
文献类型：
--
作者：
Furushima, H;Chinushi, M;Aizawa, Y
Brugada综合征的SAECG和EPS。背景：RVOT的电异常可能与Brugada综合征有关。目的：探讨信号平均心电图（SAECG）与电生理研究（EPS）之间的关系，特别关注右心室流出道传导延迟（RVOT）及其对临床特征的贡献。方法：选取24例Brugada综合征患者，男23例，女1例，年龄61±16岁。我们评估了SAECG中晚电位（LP）的存在以及右侧心前导联（V-1或V-2； RfQRS）和左侧心前导联（V-5或V-6； LfQRS）的滤过QRS持续时间以及它们之间的差异。在18例患者中，SAECG在三个不同的场合评估LP。结果：15例患者SAECG至少一次呈LP阳性；7例患者SAECG多次呈LP阳性，其中6例（86%）有心脏骤停史。心脏骤停患者的RfQRS和LfQRS差异显著大于晕厥或无症状患者；29 +/- 10、14 +/- 11 （P < 0.01）、7 +/- 5 msec （P < 0.001）。所有患者均存活，其中一名心脏骤停患者接受了ICD提供的适当的VF治疗。结论：右侧心前导联滤过QRS持续时间的显著延长可能与Brugada综合征发生心律失常事件的风险有关。
SAECG and EPS in Brugada Syndrome. Background: Electrical abnormalities in the RVOT may be involved in Brugada syndrome.Objectives: We investigated the relationship between the signal-averaged ECG (SAECG) and electrophysiologic study (EPS), especially focusing on conduction delay in the outflow tract of the right ventricle (RVOT) and its contribution to clinical characteristics.Methods: Twenty-four patients with Brugada syndrome (23 men and 1 woman; 61 +/- 16 years old) were studied. We assessed the presence of late potential (LP) in SAECG and the filtered QRS duration in the right precordial leads (V-1 or V-2; RfQRS) and in the left precordial leads (V-5 or V-6; LfQRS) and the difference between them. In 18 patients, SAECG was evaluated for an LP on three separate occasions.Results: SAECG was positive for LP in 15 patients at least once; and in 7 patients, SAECG was positive for an LP on multiple occasions, and 6 of 7 patients (86%) had a history of cardiac arrest. The difference between RfQRS and LfQRS was significantly greater in patients with cardiac arrest than in patients with syncope or in asymptomatic patients; 29 +/- 10, 14 +/- 11 (P < 0.01), and 7 +/- 5 msec (P < 0.001), respectively. All patients were alive and one patient with cardiac arrest had an appropriate VF therapy delivered by the ICD.Conclusions: The dominant prolongation of the filtered QRS duration in the right precordial leads may be related to the risk of arrhythmic event in Brugada syndrome.