Pedrón-Torrecilla J, Climent Andreu M, Millet José, Berné Paola, Brugada Josep, Brugada Ramon, Guillem Maria S
Universitat Politècnica de València, 46022 Valencia, Spain.
Annu Int Conf IEEE Eng Med Biol Soc. 2011;2011:235-8. doi: 10.1109/IEMBS.2011.6090044.
Brugada syndrome (BrS) causes sudden death in patients with structurally normal hearts. Manifestation of BrS in the ECG is dynamic and most patients do not show unequivocal signs of the syndrome during ECG screening. Electrograms (EGMs) of BrS patients show conduction delay and fractionation at the right ventricular outflow tract area (RVOT) and thus could be used for diagnosis, but their recording requires an invasive procedure. We have obtained 67-lead body surface potential mapping recordings (BSPM) of 6 BrS patients and 6 controls and computed their EGMs by solving the inverse problem of electrocardiography by using Tikhonov's regularization method. Inverse-computed EGMs presented similar activation times and durations in controls and BrS patients for apex and septum. However, RVOT EGMs showed a later activation in BrS patients than in controls (58 ± 7 vs. 39 ± 5 ms, p<0.01) and EGMs were longer (122 ± 22 vs. 85 ± 8 ms, p<0.01). Inverse-computed EGMs of BrS patients showed abnormalities consistent with those observed in electrophysiological studies and could be used for a non-invasive diagnosis and characterization of Brugada syndrome.
Brugada综合征（BrS）可导致心脏结构正常的患者猝死。BrS在心电图上的表现是动态的，大多数患者在心电图筛查期间并未表现出该综合征的确切迹象。BrS患者的心电信号（EGMs）显示右心室流出道区域（RVOT）存在传导延迟和碎裂，因此可用于诊断，但记录心电信号需要进行侵入性操作。我们获取了6例BrS患者和6例对照者的67导联体表电位标测记录（BSPM），并使用蒂霍诺夫正则化方法通过解决心电图逆问题来计算他们的心电信号。对照者和BrS患者的心尖和室间隔区域的逆计算心电信号呈现出相似的激活时间和持续时间。然而，BrS患者的RVOT心电信号的激活时间比对照者晚（58±7 vs. 39±5毫秒，p<0.01），且心电信号持续时间更长（122±22 vs. 85±8毫秒，p<0.01）。BrS患者的逆计算心电信号显示出与电生理研究中观察到的异常一致的情况，可用于Brugada综合征的无创诊断和特征描述。
