Current electrocardiographic criteria for diagnosis of Brugada pattern: a consensus report
Current electrocardiographic criteria for diagnosis of Brugada pattern: a consensus report
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DOI：
10.1016/j.jelectrocard.2012.06.004
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发表时间：
2012-09-01
影响因子：
1.3
通讯作者：
Brugada, Pedro
中科院分区：
文献类型：
--
作者：
Bayes de Luna, Antonio;Brugada, Josep;Brugada, Pedro
Brugada综合征是一种无结构异常的遗传性心脏病，被认为是由于Na通道加速失活和瞬时外向K电流（I-to）占优势而在右心室层中产生电压梯度。Brugada心电图（ECG）是Brugada综合征的特征，它可以是动态的，有时是隐蔽的，只记录在上胸导联。由于先前描述Brugada ECG模式的共识文件的局限性，特别是与2型和3型之间的差异有关，因此认为有必要制定一份新的共识报告，以建立一套新的具有更高准确度的ECG标准。在新的ECG标准中，仅考虑了2种ECG模式：模式1与其他共识的经典类型1相同（内凹模式），模式2连接了先前共识的模式2和模式3（鞍背模式）。该共识文件描述了2种模式的最重要特征，以及导致右胸导联Brugada样模式的不同情况下的鉴别诊断要点，特别是右胸支阻滞，运动员，漏斗胸，和致瘤性右心室发育不良/还讨论了Brugada表型的概念，其是Brugada模式的特征性ECG模式，其可能与多发性心肌病相关地出现和消失。与Brugada综合征无关。(C)2012 Elsevier Inc. All rights reserved.
Brugada syndrome is an inherited heart disease without structural abnormalities that is thought to arise as a result of accelerated inactivation of Na channels and predominance of transient outward K current (I-to) to generate a voltage gradient in the right ventricular layers. This gradient triggers ventricular tachycardia/ventricular fibrillation possibly through a phase 2 reentrant mechanism.The Brugada electrocardiographic (ECG) pattern, which can be dynamic and is sometimes concealed, being only recorded in upper precordial leads, is the hallmark of Brugada syndrome. Because of limitations of previous consensus documents describing the Brugada ECG pattern, especially in relation to the differences between types 2 and 3, a new consensus report to establish a set of new ECG criteria with higher accuracy has been considered necessary. In the new ECG criteria, only 2 ECG patterns are considered: pattern 1 identical to classic type 1 of other consensus (coved pattern) and pattern 2 that joins patterns 2 and 3 of previous consensus (saddleback pattern). This consensus document describes the most important characteristics of 2 patterns and also the key points of differential diagnosis with different conditions that lead to Brugada-like pattern in the right precordial leads, especially right bundle-branch block, athletes, pectus excavatum, and arrhythmogenic right ventricular dysplasia/cardiomyopathy.Also discussed is the concept of Brugada phenocopies that are ECG patterns characteristic of Brugada pattern that may appear and disappear in relation with multiple causes but are not related with Brugada syndrome. (C) 2012 Elsevier Inc. All rights reserved.