Bradycardia-dependent ECG changes in Brugada syndrome
Bradycardia-dependent ECG changes in Brugada syndrome
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DOI：
10.1253/circj.70.896
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发表时间：
2006-07-01
影响因子：
3.3
通讯作者：
Inoue, Hiroshi
中科院分区：
文献类型：
--
作者：
Mizumaki, Koichi;Fujiki, Akira;Inoue, Hiroshi
Brugada综合征（BS）患者的心室颤动（VF）主要发生在睡眠期间，因此，夜间VF的发生不仅与迷走神经活动有关，还与心动过缓相关的心电图改变有关。本研究的目的是研究的差异心动过缓依赖的变化，在心电图的症状和无症状的BS patients.Methods和结果21例BS患者分为有症状（n=9）和无症状（n=12）组。在电生理研究中，在右心房外刺激时，在RR间期为400、600、750、1,000和1,100 ms时评价ECG变化。测量V2的ST水平，以及V2和V5的QT间期。沿着RR间期从400 ms增加到1,100 ms，两组中V2的ST水平均增加;两组之间的增加没有差异。在V2和V5导联中，有症状组QT间期沿着RR间期从400 ms增加到1,100 ms的延长显著小于无症状组，RR间期为1,100 ms时的QT间期显著短于无症状组。有症状和无症状患者在心动过缓期间ST段抬高的程度相似。然而，心动过缓期间QT间期延长受到抑制是有症状患者的特征。这些独特的复极动力学可能与BS患者心动过缓期间夜间发生VF有关。
Background In patients with Brugada syndrome (BS), ventricular fibrillation (VF) occurs mainly during sleep; therefore, not only vagal activity but also bradycardia dependent changes in ECG may relate to,the nighttime occurrence of VF. The present study aimed to examine the difference in bradycardia-dependent changes in the ECG of symptomatic and asymptomatic BS patients.Methods and Results Twenty-one patients with BS were categorized into symptomatic (n=9) and asymptomatic (n=12) groups. During the electrophysiologic study, the ECG changes were evaluated at RR intervals of 400, 600, 750, 1,000 and 1,100ms during extrastimulation from the right atrium. The ST levels in V2, and the QT interval in both V2 and V5 were measured. Along with an increase in the RR interval from 400 to 1,100ms, the ST levels in V2 increased in both groups; the increase did not differ between the 2 groups. In both leads V2 and V5, the prolongation of the QT interval along with an increase in the RR interval from 400 to 1,100ms was significantly smaller and the QT intervals at an RR interval of 1,100ms were significantly shorter in the symptomatic than in the asymptomatic group.Conclusions In patients with BS, the ST elevation was augmented during bradycardia to a similar extent in both symptomatic and asymptomatic patients. However, a inhibited prolongation of the QT interval during bradycardia was characteristic of symptomatic patients. These unique repolarization dynamics could relate to the nighttime occurrence of VF during bradycardia inpatients with BS.