由于苯妥英水平高于治疗范围导致的1型Brugada波心电图表现。
Type 1 Brugada pattern ECG due to supra-therapeutic phenytoin level.
作者信息
Swe Thein, Bhattarai Bikash, Dufresne Alix
机构信息
Department of Internal Medicine, Interfaith Medical Center, Brooklyn, New York, USA.
Head of Cardiology Department, Interfaith Medical Center, Brooklyn, New York, USA.
出版信息
BMJ Case Rep. 2016 Jun 28;2016:bcr2016214899. doi: 10.1136/bcr-2016-214899.
Brugada syndrome is an inherited arrhythmogenic disease, characterised by a coved-type ST segment elevation in right precordial leads and an increased risk of sudden cardiac death due to ventricular arrhythmia. To unmask or exacerbate a Brugada ECG pattern, class IA or IC antiarrhythmic agents are used, and clinicians can predict sudden cardiac death in a high-risk patient. However, phenytoin, one of the class IB agents, may induce a Brugada pattern ECG at a supra-therapeutic level and this association has rarely been reported. We describe a case of a patient with a phenytoin level about twice as high as the therapeutic level, which led to the emergence of a type 1 Brugada pattern ECG. Awareness should be made between this important association of supra-therapeutic phenytoin level and type 1 Brugada pattern ECG because symptomatic Brugada syndrome can lead to sudden cardiac death.
布加综合征是一种遗传性致心律失常疾病，其特征为右胸前导联出现穹窿型ST段抬高以及因室性心律失常导致的心源性猝死风险增加。为了揭示或加重布加综合征心电图模式，会使用IA类或IC类抗心律失常药物，临床医生可以预测高危患者的心源性猝死。然而，IB类药物之一的苯妥英钠在超治疗水平时可能诱发布加综合征心电图模式，且这种关联鲜有报道。我们描述了一例患者，其苯妥英钠水平约为治疗水平的两倍，这导致了1型布加综合征心电图模式的出现。应认识到超治疗水平的苯妥英钠与1型布加综合征心电图模式之间的这一重要关联，因为有症状的布加综合征可导致心源性猝死。
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