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阿义马林诱发的Brugada波拟态、右束支传导阻滞，还是两者皆有？

Ajmaline-induced Brugada Phenocopy, Right Bundle Branch Block, or Both?

作者信息

Kafes Habibe, Can Irem Dilara, Yaman Nezaket Merve, Kara Meryem, Korkmaz Ahmet, Ozeke Ozcan, Cay Serkan, Ozcan Firat, Topaloglu Serkan, Aras Dursun

机构信息

Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.

出版信息

J Innov Card Rhythm Manag. 2021 Sep 15;12(9):4682-4684. doi: 10.19102/icrm.2021.120906. eCollection 2021 Sep.

DOI:10.19102/icrm.2021.120906
PMID:34595052
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8476095/
Abstract

In equivocal or suspected cases of Brugada syndrome (BrS), ajmaline testing is frequently used in the diagnostic approach. However, the administration of sodium channel blockers can not only elicit the coved ST-segment elevation characteristic of type 1 Brugada pattern but also induce right bundle branch block (RBBB), which can preclude the electrocardiographic manifestations of BrS. We describe a case report wherein RBBB posed a diagnostic challenge during the ajmaline test for suspected BrS.

摘要

在Brugada综合征（BrS）的可疑或不明确病例中，阿义马林试验常用于诊断。然而，给予钠通道阻滞剂不仅可引发1型Brugada波型特征性的穹窿型ST段抬高，还可诱发右束支传导阻滞（RBBB），这可能会掩盖BrS的心电图表现。我们描述了一例病例报告，其中在对疑似BrS进行阿义马林试验时，RBBB对诊断构成了挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cf9/8476095/263794365194/icrm-12-4682-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cf9/8476095/42d74179a5d2/icrm-12-4682-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cf9/8476095/c0df56da031a/icrm-12-4682-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cf9/8476095/263794365194/icrm-12-4682-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cf9/8476095/42d74179a5d2/icrm-12-4682-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cf9/8476095/c0df56da031a/icrm-12-4682-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cf9/8476095/263794365194/icrm-12-4682-g003.jpg

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本文引用的文献

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Eur J Gen Pract. 2019 Jul;25(3):109-115. doi: 10.1080/13814788.2019.1639667. Epub 2019 Jul 24.
2
Drug Provocation Testing in Brugada Syndrome: A Test of Uncertain Significance.Brugada综合征的药物激发试验：意义不确定的一项检查
JACC Clin Electrophysiol. 2019 Apr;5(4):513-515. doi: 10.1016/j.jacep.2019.03.003.
3
Should all individuals with suspected arrhythmias but initially nondiagnostic electrocardiogram be ordered routinely higher intercostal space ECG?
Pacing Clin Electrophysiol. 2019 Apr;42(4):489-491. doi: 10.1111/pace.13633. Epub 2019 Feb 28.
4
Read My Lips: A Positive Ajmaline Test Does Not Always Mean You Have Brugada Syndrome.请注意：阿义马林试验呈阳性并不总是意味着你患有 Brugada 综合征。
JACC Clin Electrophysiol. 2017 Dec 11;3(12):1409-1411. doi: 10.1016/j.jacep.2017.05.016. Epub 2017 Aug 30.
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Yield and Pitfalls of Ajmaline Testing in the Evaluation of Unexplained Cardiac Arrest and Sudden Unexplained Death: Single-Center Experience With 482 Families.阿马林检测在不明原因心搏骤停和猝死评估中的产量和陷阱：482 个家庭的单中心经验。
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