Chen Xinguang, Zhao Hongyan, Sun Ling, Zhu Wenwu, Zhang Fengxiang
Section of Pacing and Electrophysiology, Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Section of Pacing and Electrophysiology, Division of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China,
Cardiology. 2020;145(3):130-135. doi: 10.1159/000505642. Epub 2020 Feb 3.
Changes in electrocardiogram (ECG) parameters and the incidence of arrhythmic events in patients with fever-induced Brugada syndrome (BrS) remain unknown.
We aimed to investigate the effect of hyperthermia on the ECG pattern and the occurrence of fever-triggered arrhythmic events (FTAEs) in patients with fever-induced BrS.
We retrospectively analyzed a series of fever-induced BrS cases from January 1966 to November 2018. Clinical characteristics and ECG parameters were evaluated in the presence or absence of fever.
Syncope and implantable cardioverter defibrillator implantation occurred more frequently in BrS patients with FTAEs than in patients without FTAEs. In BrS patients <16 years old, more arrhythmia events occurred in patients with FTAEs than in patients without FTAEs (p = 0.04). During follow-up, 2 patients in the FTAEs group suffered new malignant arrhythmic events. Compared to the afebrile state, the J point increased significantly in precordial leads V1, V2, and V3 during the febrile state (all p < 0.01). The corrected QTpeak intervals in V1 and V2 were significantly longer in the FTAEs group than in the non-FTAEs group (354.5 ± 37.0 vs. 334.3 ± 45.5 ms, p < 0.01 and 368.0 ± 43.4 vs. 330.9 ± 41.5 ms, p < 0.01, respectively). An increased corrected QT dispersion and a lengthened corrected Tpeak-Tend dispersion were also observed during fever.
Fever may not only reveal BrS but also induce life-threatening arrhythmic events, especially in children and adolescents.
发热诱发的Brugada综合征（BrS）患者的心电图（ECG）参数变化及心律失常事件的发生率尚不清楚。
我们旨在研究高温对发热诱发的BrS患者心电图模式及发热触发的心律失常事件（FTAEs）发生情况的影响。
我们回顾性分析了1966年1月至2018年11月期间一系列发热诱发的BrS病例。在有或无发热的情况下评估临床特征和ECG参数。
发生FTAEs的BrS患者比未发生FTAEs的患者更频繁地出现晕厥和植入式心律转复除颤器植入。在年龄小于16岁的BrS患者中，发生FTAEs的患者比未发生FTAEs的患者出现更多心律失常事件（p = 0.04）。随访期间，FTAEs组有2例患者发生新的恶性心律失常事件。与无热状态相比，发热状态下胸前导联V1、V2和V3的J点显著升高（所有p < 0.01）。FTAEs组V1和V2导联的校正QTpeak间期显著长于非FTAEs组（分别为354.5 ± 37.0 vs. 334.3 ± 45.5 ms，p < 0.01和368.0 ± 43.4 vs. 330.9 ± 41.5 ms，p < 0.01）。发热期间还观察到校正QT离散度增加和校正Tpeak - Tend离散度延长。
发热不仅可能揭示BrS，还可能诱发危及生命的心律失常事件，尤其是在儿童和青少年中。
