Letsas Konstantinos P, Asvestas Dimitrios, Baranchuk Adrian, Liu Tong, Georgopoulos Stamatis, Efremidis Michael, Korantzopoulos Panagiotis, Bazoukis George, Tse Gary, Sideris Antonios, Takagi Masahiko, Ehrlich Joachim R
Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece.
Division of Cardiology, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada.
Pacing Clin Electrophysiol. 2017 Dec;40(12):1332-1345. doi: 10.1111/pace.13214. Epub 2017 Nov 15.
Brugada syndrome (BrS) is a primary electrical disease associated with increased risk of sudden cardiac death due to polymorphic ventricular arrhythmias. The prognosis, risk stratification, and management of asymptomatic individuals remain the most controversial issues in BrS. Furthermore, the decision to manage asymptomatic patients with an implantable cardioverter-defibrillator should be made after weighing the potential individual risk of future arrhythmic events against the risk of complications associated with the implant and follow-up of patients living with such devices, and the accompanying impairment of the quality of life. Several clinical, electrocardiographic, and electrophysiological markers have been proposed for risk stratification of subjects with BrS phenotype, but the majority have not yet been tested in a prospective manner in asymptomatic individuals. Recent data suggest that current risk factors are insufficient and cannot accurately predict sudden cardiac death events in this setting. This systematic review aims to discuss contemporary data regarding prognosis, risk stratification, and management of asymptomatic individuals with diagnosis of Brugada electrocardiogram pattern and to delineate the therapeutic approach in such cases.
Brugada综合征（BrS）是一种原发性电疾病，与多形性室性心律失常导致的心源性猝死风险增加相关。无症状个体的预后、风险分层及管理仍是BrS中最具争议的问题。此外，对于无症状患者植入植入式心脏复律除颤器的决策，应在权衡未来心律失常事件的潜在个体风险与植入及随访此类装置相关并发症风险以及随之而来的生活质量受损情况之后做出。已提出多种临床、心电图及电生理标志物用于BrS表型患者的风险分层，但大多数尚未在前瞻性研究中对无症状个体进行检验。近期数据表明，目前的风险因素并不充分，无法准确预测该情况下的心源性猝死事件。本系统综述旨在讨论有关诊断为Brugada心电图模式的无症状个体的预后、风险分层及管理的当代数据，并阐述此类病例的治疗方法。
