Hôpital Cardiologique du Haut Lévèque, CHU de Bordeaux and IHU-LIRYC, Pessac, France.
Cardiology and Electrophysiology Unit, Azienda USL Toscana, Florence, Italy.
J Cardiovasc Electrophysiol. 2020 Apr;31(4):975-984. doi: 10.1111/jce.14361. Epub 2020 Jan 29.
The incidence of atrial fibrillation (AF) in Brugada syndrome (BrS) has been reported at between 9% and 53% by different series, but the true prevalence is unknown. However, AF may be the presenting feature in some patients. The underlying mechanisms for AF may be a combination of multiple factors, genetic or acquired, that may impact upon autonomic function, atrial structure, and conduction velocities or other unknown factors. The presence of AF has been associated with a more malignant course, with a greater incidence of syncope and ventricular arrhythmias, thus acting as marker of more advanced disease. Regarding the management of patients with AF, antiarrhythmic drugs effective in preventing malignant arrhythmias in BrS such as quinidine or invasive treatment with pulmonary vein isolation (PVI) may be useful in AF treatment. In this review, we aim to present the current perspectives regarding the genetics, pathophysiology, management, and prognosis of AF in patients with BrS.
Brugada 综合征(BrS)中心房颤动(AF)的发生率在不同的系列报道中为 9%至 53%不等,但真实的患病率尚不清楚。然而,AF 可能是一些患者的首发表现。AF 的潜在机制可能是多种因素的综合作用,包括遗传或获得性因素,这些因素可能影响自主神经功能、心房结构和传导速度或其他未知因素。AF 的存在与更恶性的病程相关,晕厥和室性心律失常的发生率更高,因此可作为疾病更严重的标志物。关于 AF 患者的管理,在 BrS 中有效预防恶性心律失常的抗心律失常药物(如奎尼丁)或侵入性的肺静脉隔离(PVI)治疗可能对 AF 治疗有用。在这篇综述中,我们旨在介绍目前关于 BrS 患者 AF 的遗传学、病理生理学、管理和预后的观点。