QT-interval prolongation in right precordial leads: An additional electrocardiographic hallmark of Brugada Syndrome
QT-interval prolongation in right precordial leads: An additional electrocardiographic hallmark of Brugada Syndrome
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DOI：
10.1016/j.jacc.2003.07.005
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发表时间：
2003-11-05
影响因子：
24
通讯作者：
Rizzon, P
中科院分区：
文献类型：
--
作者：
Pitzalis, MV;Anaclerio, M;Rizzon, P
目的 本研究的目的是评估 Brugada 综合征典型心电图 (ECG) 模式（即右束支传导阻滞、凹型 ST 段抬高和右心前导联 T 波倒置）的发生是否以右心前导联 QT 间期延长为特征。 背景 有人认为 Brugada 综合征的典型心电图模式是由于动作电位第 1 相期间净内向电流减少，这也导致右心外膜延长。 方法 32 名受试者（19 名男性），年龄 37 +/- 15 岁，基线心电图可疑，或为 Brugada 综合征患者的亲属，在氟卡尼给药前后进行 12 导联心电图检查。 结果 14 名受试者氟卡尼测试呈阴性，18 名受试者氟卡尼测试呈阳性。给予氟卡尼后，阳性心电图的特点是右心前导联中校正心率 (QTc) 延长的 QT 间期高于阴性心电图（V-1 中为 78.2 +/- 35.5 ms 与 22.0 +/- 28.4 ms，V-2 中为 107.1 +/- 43.8 ms 与 26.7 +/- 30.1 ms；p < 0.01），而左心前导联的 QTc 延长没有差异（V-5 中 55.2 +/- 25.3 ms 与 35.1 +/- 28.1 ms，V-6 中 53.1 +/- 32.8 ms 与 27.3 +/- 22.4 ms；p = NS）。 结论 根据电生理学背景，典型的心电图模式Brugada 综合征的另一个特点是右心前导联 QT 间期显着延长。 (C) 2003 年由美国心脏病学会基金会资助。
OBJECTIVES The aim of this study was to evaluate whether the occurrence of the Brugada Syndrome typical electrocardiogram (ECG) pattern (i.e., right bundle branch block, coved-type ST-segment elevation, and T-wave inversion in the right precordial leads) is characterized by a concomitant lengthening of QT intervals in the right precordial leads.BACKGROUND It has been suggested that the typical ECG pattern of Brugada syndrome is due to a decreased net inward current during phase 1 of the action potential, which also leads to its prolongation in the right epicardium.METHODS Thirty-two subjects (19 males) age 37 +/- 15 years with a suspicious baseline ECG, or who were relatives of Brugada syndrome patients, underwent 12-lead ECG before and after the administration of flecainide.RESULTS The flecainide test was negative in 14 and positive in 18 subjects. After flecainide administration, the positive ECGs were characterized by a greater QT interval corrected for heart rate (QTc) prolongation in the right precordial leads than that in the negative ECGs (78.2 +/- 35.5 ms vs. 22.0 +/- 28.4 ms in V-1 and 107.1 +/- 43.8 ms vs. 26.7 +/- 30.1 ms in V-2; p < 0.01), whereas there was no difference in the QTc prolongation in the left precordial leads (55.2 +/- 25.3 ms vs. 35.1 +/- 28.1 ms in V-5 and 53.1 +/- 32.8 ms vs. 27.3 +/- 22.4 ms in V-6; p = NS).CONCLUSIONS In accordance with the electrophysiological background, the typical ECG pattern of Brugada syndrome is also characterized by a considerable prolongation of the QT interval in right precordial leads. (C) 2003 by the American College of Cardiology Foundation.