Ohkubo Kimie, Watanabe Ichiro, Okumura Yasuo, Ashino Sonoko, Kofune Masayoshi, Ohta Masakatsu, Nakai Toshiko, Kunimoto Satoshi, Kasamaki Yuji, Hirayama Atsushi
Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Int Heart J. 2009 Jul;50(4):477-87. doi: 10.1536/ihj.50.477.
This study was designed to evaluate whether the right ventricular outflow tract (RVOT) is the arrhythmogenic focus in Brugada syndrome. We enrolled 45 patients with Brugada-type ECG who underwent programmed ventricular stimulation and inducible ventricular fibrillation (VF). In 25 of these 32 patients, repetitive VT was observed before degeneration into VF. The QRS morphology of surface ECG and intracardiac electrograms were evaluated to determine the origin of the ventricular tachycardia (VT) that degenerated into VF. The VT morphology was a left bundle branch block pattern with an inferior axis in 22 of 28 VTs and the intracardiac conduction sequence during VT revealed activation from the RVOT to the RV apex in these 22 VTs. The majority of the patients with Brugada syndrome showed repetitive VT originating from the RVOT that degenerated into VF. The RVOT may be an arrhythmogenic focus in patients with Brugada syndrome.
本研究旨在评估右心室流出道（RVOT）是否为Brugada综合征的致心律失常灶。我们纳入了45例接受程控心室刺激且可诱发心室颤动（VF）的Brugada型心电图患者。在这45例患者中的32例中，有25例在演变为VF之前观察到了反复性室性心动过速（VT）。评估体表心电图和心内电图的QRS形态，以确定演变为VF的室性心动过速（VT）的起源。在28例VT中的22例中，VT形态为左束支传导阻滞图形且电轴向下，这22例VT的心内传导顺序显示在VT期间激动从RVOT传至右心室心尖部。大多数Brugada综合征患者表现为起源于RVOT的反复性VT并演变为VF。RVOT可能是Brugada综合征患者的致心律失常灶。
