Arrhythmia Unit, Onassis Cardiac Surgery Center, 17674 Athens, Greece.
Department of Cardiology, University of Ioannina Medical School, 45110 Ioannina, Greece.
Rev Cardiovasc Med. 2022 Jan 25;23(2):44. doi: 10.31083/j.rcm2302044.
Brugada syndrome (BrS) is a complex arrhythmogenic disease displaying electrical and micro-structural abnormalities mainly located at the epicardium of the right ventricular outflow tract (RVOT). It is well-known that fibrosis, fatty infiltration, inflammation and reduced gap junction expression have been demonstrated at the epicardial anterior aspect of the RVOT providing the arrhythmogenic substrate for ventricular arrhythmic events in BrS. A number of models have been proposed for the risk stratification of patients with BrS. Endocardial unipolar electroanatomical mapping is an emerging tool that has been reintroduced to identify and quantify epicardial electrical abnormalities. Interestingly, current findings correlate the presence of large-sized endocardial unipolar electroanatomical abnormalities with either ventricular fibrillation inducibility during programmed ventricular stimulation or symptom status. This review aims to present existing data about the role of endocardial unipolar electroanatomical mapping for the identification of RVOT epicardial abnormalities as well as its potential clinical implications in risk stratification of BrS.
Brugada 综合征（BrS）是一种复杂的心律失常性疾病，主要表现为右心室流出道（RVOT）心外膜的电和微观结构异常。众所周知，纤维化、脂肪浸润、炎症和缝隙连接表达减少已在 RVOT 的心外膜前表面得到证实，为 BrS 中的室性心律失常事件提供了心律失常基质。已经提出了许多 BrS 患者的风险分层模型。心内膜单极电图标测是一种新兴的工具，它已被重新引入以识别和量化心外膜的电异常。有趣的是，目前的研究结果表明，大的心内膜单极电图异常与程序心室刺激期间的心室颤动诱导性或症状状态相关。本综述旨在介绍关于心内膜单极电图标测在识别 RVOT 心外膜异常中的作用及其在 BrS 风险分层中的潜在临床意义的现有数据。
