Bigi Mohamad Ali Babai, Aslani Amir, Shahrzad Shahab
Cardiology Department, Namazee Hospital, Shiraz University of Medical Sciences, Zand Avenue, PO Box 71935-1334, Shiraz, Iran.
Europace. 2007 Oct;9(10):947-50. doi: 10.1093/europace/eum110. Epub 2007 May 31.
Atrial arrhythmias have been reported in patients with Brugada syndrome. The aim of this study was to evaluate clinical predictors of atrial fibrillation (AF) in Brugada syndrome.
Patients diagnosed with Brugada ECG pattern were enrolled in the study. Type 1, 2, and 3 Brugada ECG pattern was found in 28, 56, and 31 patients, respectively. A total of 85 healthy age and gender-matched subjects were selected as a control group. Mean age, maximum P-wave duration (P(max)), P-wave dispersion (P(disp)), and left atrial dimension were not significantly different between patients and controls. There were no differences between P(max), P(disp), and left atrial dimension of the type 1, 2, and 3 Brugada patients. Spontaneous paroxysmal AF was detected in 15 of 28 type 1 Brugada patients (53%) and none of the type 2 and 3 Brugada patients. All 15 patients with AF had at least one episode of paroxysmal AF and none of the patients showed persistent or chronic AF. All 15 patients who had paroxysmal AF had previous life threatening cardiac events. In contrast, paroxysmal AF did not occur in type 1 Brugada patients without previous life threatening cardiac events. In multiple regression analysis, only the occurrence of previous life threatening cardiac events was a risk factor for paroxysmal AF (P = 0.0001).
It is concluded that the most important predictor of AF in Brugada syndrome is the occurrence of previous life threatening cardiac events.
已有报道称布加综合征患者会出现房性心律失常。本研究的目的是评估布加综合征患者发生心房颤动（AF）的临床预测因素。
诊断为布加心电图模式的患者纳入本研究。分别在28例、56例和31例患者中发现1型、2型和3型布加心电图模式。总共选择85名年龄和性别匹配的健康受试者作为对照组。患者和对照组之间的平均年龄、最大P波时限（P(max)）、P波离散度（P(disp)）和左心房内径无显著差异。1型、2型和3型布加综合征患者的P(max)、P(disp)和左心房内径之间无差异。在28例1型布加综合征患者中有15例（53%）检测到自发性阵发性房颤，而2型和3型布加综合征患者均未检测到。所有15例房颤患者均至少有一次阵发性房颤发作，且无一例患者表现为持续性或慢性房颤。所有15例发生阵发性房颤的患者既往均有危及生命的心脏事件。相比之下，既往无危及生命心脏事件的1型布加综合征患者未发生阵发性房颤。在多元回归分析中，只有既往发生危及生命的心脏事件是阵发性房颤的危险因素（P = 0.0001）。
得出结论，布加综合征患者发生房颤的最重要预测因素是既往发生危及生命的心脏事件。
