Bordeaux University Hospital, Bordeaux, France.
Heart Rhythm. 2012 Aug;9(8):1272-9. doi: 10.1016/j.hrthm.2012.04.013. Epub 2012 Apr 10.
The report from the 2nd Consensus Committee on BrS suggests that all patients with syncope without a "clear extracardiac cause" should have an implantable cardioverter-defibrillator (ICD). However, a clear extracardiac cause for syncope may be difficult to prove.
The purpose of this study was to characterize syncope in patients with Brugada syndrome (BrS).
All patients diagnosed with BrS at our institution between 1999 and 2010 were enrolled in a prospective registry. Patients with suspected arrhythmic syncope (group 1) were compared to patients with nonarrhythmic syncope (group 2) and to patients with syncope of doubtful origin (group 3).
Of 203 patients with BrS, 57 (28%; 44 male, age 46 ± 12 years) experienced at least 1 syncope. Group 1 consisted of 23 patients, all of whom received an ICD. In group 2 (17 patients), 3 received an ICD because of a positive electrophysiologic study. In group 3 (17 patients), 6 received an implantable loop recorder and 6 received an ICD. After mean follow-up of 65 ± 42 months, 14 patients in group 1 remained asymptomatic, 4 had recurrent syncope, and 6 had appropriate ICD therapy. In group 2, 9 patients remained asymptomatic and 7 had recurrent neurocardiogenic syncope. In group 3, 7 remained asymptomatic and 9 had recurrent syncope. One patient from each group died from a noncardiac cause.
In the present study, syncope occurred in 28% of patients with BrS. The ventricular arrhythmia rate was 5.5% per year in group 1. In 30%, the etiology of the syncope was questionable. No sudden cardiac death occurred in groups 2 and 3.
第二届 Brugada 综合征（BrS）共识委员会的报告建议，所有不明原因晕厥且无“明确心外原因”的患者都应植入埋藏式心脏复律除颤器（ICD）。然而，晕厥的明确心外原因可能难以证实。
本研究旨在描述 Brugada 综合征（BrS）患者的晕厥特征。
本机构于 1999 年至 2010 年间诊断为 BrS 的所有患者均纳入前瞻性注册研究。将疑似心律失常性晕厥（第 1 组）的患者与非心律失常性晕厥（第 2 组）及原因不明性晕厥（第 3 组）患者进行比较。
203 例 BrS 患者中，57 例（28%；44 例男性，年龄 46±12 岁）至少发生过 1 次晕厥。第 1 组有 23 例患者，所有患者均植入 ICD。第 2 组有 17 例患者，其中 3 例因电生理检查阳性而植入 ICD。第 3 组有 17 例患者，其中 6 例植入植入式环路记录器，6 例植入 ICD。平均随访 65±42 个月后，第 1 组 14 例患者无症状，4 例患者再次发生晕厥，6 例患者 ICD 治疗有效。第 2 组中，9 例患者无症状，7 例患者再次发生神经心源性晕厥。第 3 组中，7 例患者无症状，9 例患者再次发生晕厥。每组各有 1 例患者因非心脏原因死亡。
本研究中，28%的 BrS 患者发生晕厥。第 1 组患者每年发生室性心律失常的比例为 5.5%。30%的患者晕厥病因不明。第 2 组和第 3 组均未发生心源性猝死。
