Sabbag Avi, Amoroso Gisella, Tomer Orr, Conte Giulio, Beinart Roy, Nof Eyal, Özkartal Tardu, Ollitrault Pierre, Laredo Mikael, Tovia-Brodie Oholi, Gandjbakhch Estelle, de Benedictis Michele, Ter Bekke Rachel M A, Milman Anat
Leviev Heart Institute The Chaim Sheba Medical Center Tel Hashomer Israel.
Sackler School of Medicine Tel Aviv University Tel Aviv Israel.
J Arrhythm. 2024 May 29;40(4):982-990. doi: 10.1002/joa3.13053. eCollection 2024 Aug.
Diagnosis of Brugada syndrome (BrS) may be established by exposing a Type 1 Brugada pattern using a sodium channel blocker. Data on the outcomes of different patient populations with drug-induced Type 1 Brugada pattern are limited. The present study reports on the characteristics and outcome of subjects with ajmaline induced Type 1 Brugada pattern.
A multicenter retrospective study including all consecutive cases of ajmaline-induced Type 1 Brugada pattern from seven centers.
A total of 260 patients (69.9% males, mean age 43.4 ± 13.5) were included. Additional characteristics included history of syncope ( = 56, 21.5%), family history of BrS ( = 58, 22.3%) or sudden cardiac death ( = 47, 18.1%) and ventricular fibrillation ( = 3, 1.2%). Patients were divided into those meeting current diagnostic criteria for drug-induced BrS (DIBrS) and compared to the drug-induced Brugada pattern (DIBrECG). Females were significantly overrepresented in the DIBrS group ( = 50, 40% vs. = 29, 21.5%, = .001). A significantly higher prevalence of type 2/3 Brugada ECG at baseline was found in the DIBrECG group ( = 108, 80.8% vs. = 75, 60% in the DIBrS, = .026). During a median follow up of three (IQR 1.50-5.32) years, a single event of significant arrhythmia occurred in the DIBrS group.
Less than half of subjects with ajmaline-induced Brugada pattern met current criteria for BrS. These individuals had very low rate of adverse outcomes during a follow up of 3 years, irrespective of the indication for the test or eligibility for the BrS diagnosis.
布加综合征（BrS）的诊断可通过使用钠通道阻滞剂诱发出1型布加图形来确立。关于不同患者群体出现药物诱发1型布加图形的预后数据有限。本研究报告了阿义马林诱发1型布加图形患者的特征及预后。
一项多中心回顾性研究，纳入了来自七个中心所有连续的阿义马林诱发1型布加图形病例。
共纳入260例患者（男性占69.9%，平均年龄43.4±13.5岁）。其他特征包括晕厥史（n = 56，21.5%）、布加综合征家族史（n = 58，22.3%）或心源性猝死家族史（n = 47，18.1%）以及室颤（n = 3，1.2%）。患者被分为符合当前药物诱发布加综合征（DIBrS）诊断标准的患者，并与药物诱发布加图形（DIBrECG）患者进行比较。DIBrS组女性比例显著过高（n = 50，40% 对比 n = 29，21.5%，P = 0.001）。DIBrECG组基线时2/3型布加心电图的患病率显著更高（n = 108，80.8% 对比 DIBrS组的n = 75，60%，P = 0.026）。在中位随访3年（四分位间距1.50 - 5.32年）期间，DIBrS组发生了1例严重心律失常事件。
阿义马林诱发布加图形的患者中不到一半符合当前布加综合征的标准。在3年的随访期间，这些个体不良预后发生率非常低，无论检查的指征或布加综合征诊断的资格如何。
