Hasdemir Can, Sahin Hatice, Duran Gulten, Orman Mehmet N, Kocabas Umut, Payzin Serdar, Aydin Mehmet, Antzelevitch Charles
Department of Cardiology Ege University School of Medicine Izmir Turkey.
Department of Biostatistics and Medical Informatics Ege University School of Medicine Izmir Turkey.
J Arrhythm. 2022 May 6;38(4):633-641. doi: 10.1002/joa3.12729. eCollection 2022 Aug.
The coexistence of clinical atrioventricular nodal reentrant tachycardia (AVNRT) and drug-induced type 1 Brugada pattern (DI-Type 1 BrP) has been previously reported. The present study was designed to determine the 12-lead ECG characteristics at baseline and during AVNRT and to identify a subset of 12-lead ECG variables of benefit associated with underlying Brugada syndrome (BrS)/DI-Type 1 BrP among patients with slow/fast AVNRT.
A total of 40 (11 numerical/29 categorical) 12-lead ECG parameters were analyzed and compared between patients with ( = 69) and without ( = 104) BrS/DI-Type1-BrP matched for age, female gender, body mass index, left ventricular ejection fraction and comorbid conditions. Five distinct types of ECG pattern (Type A/B/C/D/E) in V1-V2 leads during AVNRT were defined.
A total of nine electrocardiographic variables, four at baseline, and five during AVNRT were identified. At baseline, patients with BrS/DI-Type 1 BrP had higher prevalence of interatrial block, leftward shift of frontal plane QRS axis, the absence of normal QRS pattern (the presence of rSr' pattern or type 2/3 Brugada pattern) in V1-V2 and QRS fragmentation in inferior leads compared to patients without BrS/DI-Type 1 BrP. During AVNRT, patients with BrS/DI-Type 1 BrP had higher prevalence of Type A ECG pattern ("coved-type" ST-segment elevation) in V1-V2, Type C ECG pattern (pseudo-r' deflection in V and "RBBB-like" pattern in V), pseudo-r' deflection in V, QRS fragmentation in inferior leads and "isolated" QRS fragmentation/notching/slurring in aVL compared to patients without BrS/DI-Type 1 BrP.
We identify several electrocardiographic variables that point to an underlying type 1 BrP among patients with slow/fast AVNRT.
临床房室结折返性心动过速（AVNRT）与药物诱导的1型Brugada波型（DI-Type 1 BrP）并存的情况此前已有报道。本研究旨在确定基线及AVNRT发作期间的12导联心电图特征，并在缓慢/快速AVNRT患者中识别出与潜在Brugada综合征（BrS）/DI-Type 1 BrP相关的有益的12导联心电图变量子集。
对年龄、女性性别、体重指数、左心室射血分数和合并症相匹配的有（n = 69）和无（n = 104）BrS/DI-Type1-BrP的患者进行了总共40项（11项数值型/29项分类型）12导联心电图参数的分析和比较。定义了AVNRT发作期间V1-V2导联中五种不同类型的心电图模式（A/B/C/D/E型）。
共识别出9个心电图变量，其中4个在基线时出现，5个在AVNRT发作期间出现。基线时与无BrS/DI-Type 1 BrP的患者相比，有BrS/DI-Type 1 BrP的患者房内阻滞患病率更高、额面QRS电轴左偏、V1-V2导联无正常QRS波型（存在rSr'波型或2/3型Brugada波型）以及下壁导联QRS波碎裂。在AVNRT发作期间，与无BrS/DI-Type 1 BrP的患者相比，有BrS/DI-Type 1 BrP的患者V1-V2导联A型心电图模式（“穹窿型”ST段抬高）、C型心电图模式（V1导联假性r'波和V2导联“类右束支传导阻滞”波型）、V1导联假性r'波、下壁导联QRS波碎裂以及aVL导联“孤立的”QRS波碎裂/切迹/顿挫的患病率更高。
我们识别出了几个心电图变量，这些变量表明缓慢/快速AVNRT患者存在潜在的1型BrP。
