Adler Arnon
aDepartment of Cardiology, Tel Aviv Medical Center bTel Aviv University, Tel Aviv, Israel.
Curr Opin Cardiol. 2016 Jan;31(1):37-45. doi: 10.1097/HCO.0000000000000238.
Asymptomatic patients with Brugada syndrome (BrS) have a small, but not trivial, risk of cardiac events. Their risk stratification and its impact on their management are controversial. The review focuses on the clinical aspects of BrS with special emphasis on the asymptomatic patient.
Emerging data suggest that drug and fever-induced type I Brugada patterns are more common than previously appreciated. Although preliminary, these data may imply that asymptomatic patients with induced Brugada pattern are at an even lower risk than currently estimated.The latest data regarding induced ventricular arrhythmias during electrophysiological studies support its use as an indication for an implantable cardioverter defibrillator; however, this issue remains highly controversial.Several new risk markers, such as presence of the Brugada pattern in infero-lateral leads or the concomitant finding of an early repolarization pattern, have recently been proposed.
Most asymptomatic BrS patients are at low risk of cardiac events. The presence of new risk markers in this population may prompt consideration of primary prevention measures; however, data supporting this approach are still limited.
无症状的Brugada综合征（BrS）患者发生心脏事件的风险虽小，但并非微不足道。其风险分层及其对治疗的影响存在争议。本综述重点关注BrS的临床方面，特别强调无症状患者。
新出现的数据表明，药物和发热诱发的I型Brugada波比之前认为的更为常见。尽管这些数据尚属初步，但可能意味着诱发Brugada波的无症状患者的风险比目前估计的还要低。关于电生理研究期间诱发室性心律失常的最新数据支持将其作为植入式心律转复除颤器的植入指征；然而，这个问题仍然极具争议。最近提出了几种新的风险标志物，如下侧壁导联出现Brugada波或同时发现早期复极模式。
大多数无症状的BrS患者发生心脏事件的风险较低。这一人群中新风险标志物的出现可能促使考虑采取一级预防措施；然而，支持这种方法的数据仍然有限。
