Chokesuwattanaskul Ronpichai, Nademanee Koonlawee
Faculty of Medicine, Division of Cardiovascular Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, 10330, Thailand.
Bumrungrad Hospital, Bangkok, Thailand.
Curr Cardiol Rep. 2021 Apr 24;23(5):54. doi: 10.1007/s11886-021-01479-2.
To discuss the role of catheter ablation in treating life-threatening ventricular arrhythmias associated with Brugada syndrome (BrS), by presenting recent findings of BrS arrhythmogenic substrate, mechanisms underlying ventricular arrhythmias, and how they can be treated with catheter ablation.
Almost three decades ago when the clinical entity of Brugada syndrome (BrS) was described in patients who had abnormal coved-type ST elevation in the right precordial EKG leads in patients who had no apparent structural heart disease but died suddenly from ventricular fibrillation. Since its description, the syndrome has galvanized explosive research in this field over the past decades, driving major progress toward better understanding of BrS, gaining knowledge of the genetic pathophysiology and risk stratification of BrS, and creating significant advances in therapeutic modalities. One of such advances is the ability for electrophysiologists to map and identify the arrhythmogenic substrate sites of BrS, which serve as good target sites for catheter ablation. Subsequently, several studies have shown that catheter ablation of these substrates normalizes the Brugada ECG pattern and is very effective in eliminating these substrates and preventing recurrent VF episodes. Catheter ablation has become an important addition for treatment of symptomatic BrS patients with recurrent VT/VF episodes.
通过介绍近期关于Brugada综合征（BrS）致心律失常基质、室性心律失常机制以及如何通过导管消融治疗这些机制的研究结果，探讨导管消融在治疗与Brugada综合征相关的危及生命的室性心律失常中的作用。
近三十年前，Brugada综合征（BrS）的临床实体在右胸前导联心电图出现异常穹窿型ST段抬高、无明显结构性心脏病但因室颤突然死亡的患者中被描述。自其被描述以来，在过去几十年里该综合征激发了该领域的大量研究，推动了在更好地理解BrS、了解其遗传病理生理学和风险分层以及在治疗方式上取得重大进展等方面的主要进步。其中一项进展是电生理学家能够绘制并识别BrS的致心律失常基质部位，这些部位是导管消融的良好靶点。随后，多项研究表明，对这些基质进行导管消融可使Brugada心电图模式正常化，并且在消除这些基质和预防室颤复发方面非常有效。导管消融已成为治疗有复发性室性心动过速/室颤发作的症状性BrS患者的重要补充治疗方法。
