Nakazawa Kiyoshi
Department of Internal Medicine, Asao Hospital, Kawasaki, Japan.
Kyobu Geka. 2007 Dec;60(13):1171-6.
Brugada syndrome is characterized by the right bundle branch block type electrocardiogram (ECG) with ST-segment elevation and ventricular fibrillation (Vf) attack in patients without obvious heart disease. Its background is considered to be the genetic Na channelopathy. The coved type is a typical morphology and is classified into type 1 in the European Society of Cardiology (ESC). In general, the coved type and the saddel-back type (type 2, 3 in the ESC) are interchangeable, and the latter is more frequently detected clinically. For diagnosis of the Brugada syndrome, confirmation of the type 1 morphology is needed. Administration of Na channel blocker, pilsicainide, is a sensitive test for confirmation of the type 1. When the type 1 has one of 7 items recommended by the ESC, the patient is diagnosed with Brugada syndrome. ECG finding alone is classified into patient with Brugada type ECG. As there is no reliable medical treatment, implantation of a cardioverter defibrillator is indicated in patients with Brugada syndrome, and observation alone in those with Brugada type ECG.
Brugada综合征的特征是在无明显心脏病的患者中出现右束支传导阻滞型心电图（ECG）伴ST段抬高及室颤（Vf）发作。其病因被认为是遗传性钠通道病。穹窿型是典型的形态，在欧洲心脏病学会（ESC）中被归类为1型。一般来说，穹窿型和鞍背型（ESC中的2型、3型）是可相互转换的，后者在临床上更常被检测到。对于Brugada综合征的诊断，需要确认1型形态。给予钠通道阻滞剂吡西卡尼是确认1型的敏感试验。当1型具备ESC推荐的7项中的一项时，患者被诊断为Brugada综合征。仅根据心电图表现则分类为Brugada型心电图患者。由于没有可靠的药物治疗方法，Brugada综合征患者需植入心脏复律除颤器，而Brugada型心电图患者则仅进行观察。
