Class I Antiarrhythmic Drug and Coronary Vasospasm‐Induced T Wave Alternans and Ventricular Tachyarrhythmia in a Patient with Brugada Syndrome and Vasospastic Angina
Class I Antiarrhythmic Drug and Coronary Vasospasm‐Induced T Wave Alternans and Ventricular Tachyarrhythmia in a Patient with Brugada Syndrome and Vasospastic Angina
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I 类抗心律失常药物与冠状动脉痉挛引起的 T 波交替和室性快速心律失常在 Brugada 综合征和血管痉挛性心绞痛患者中的应用
DOI：
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发表时间：
2002
期刊：
影响因子：
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通讯作者：
Y. Aizawa
中科院分区：
文献类型：
--
作者：
Y. Chinushi;M. Chinushi;Tatunari Toida;Y. Aizawa
Brugada综合征和血管痉挛心绞痛中的T波交替。患者男，50岁，有一过性胸痛和心悸的病史。静息时12导联心电图显示窦性心律正常。V1~V3导联ST段轻度抬高。在住院期间，出现了心房颤动，口服了匹西卡胺。给药30分钟后，心电图显示V1至V3导联ST段明显抬高，V2和V3导联可见T波交替。自终性室性心动过速发生于频发室性早搏，呈左束支传导阻滞。冠状动脉造影正常，但在血管痉挛心绞痛激发试验中，左冠状动脉注入乙酰胆碱可导致左前降支和回旋支完全闭塞。I、aVL、V3~V6导联ST段明显抬高，V4、V5导联可见QT/T交替，室性快速性心律失常发生。Brugada综合征和血管痉挛心绞痛并存，T波交替可作为此类患者室性快速性心律失常的预测指标。
T Wave Alternans in Brugada Syndrome and Vasospastic Angina. A 50‐year‐old man presented with a history of transient chest pain and palpitations. The 12‐lead ECG at rest showed normal sinus rhythm. A slight ST segment elevation was observed in leads V1 to V3. During hospitalization, atrial fibrillation developed, and oral pilsicainide was administered. Thirty minutes after the drug was given, the ECG showed marked ST segment elevation in leads V1 to V3, and T wave alternans became visible in leads V2 and V3. Self‐terminating ventricular tachycardia was initiated following frequent ventricular premature complexes, which showed a left bundle branch block pattern. The coronary angiogram was normal, but in the provocation test of vasospastic angina, acetylcholine administration into the left coronary artery resulted in complete occlusion of the left anterior descending and circumflex arteries. Marked ST segment elevation developed in leads I, aVL, and V3 to V6 concomitant with visible QT/T alternans in leads V4 and V5, and ventricular tachyarrhythmia was initiated. Brugada syndrome and vasospastic angina coexisted in this patient, and T wave alternans can be used as a predictor of ventricular tachyarrhythmias in such patients.
影响因子：
37.8
作者：
Yan, GX;Antzelevitch, C
通讯作者：
Antzelevitch, C
影响因子：
158.5
作者：
ROSENBAUM, DS;JACKSON, LE;COHEN, RJ
通讯作者：
COHEN, RJ
影响因子：
37.8
作者：
Pastore, JM;Girouard, SD;Rosenbaum, DS
通讯作者：
Rosenbaum, DS