Lorga Filho A, Primo J, Brugada J, Brugada P
Cardiovascular Research and Teaching Institute, Aalst, Bélgica.
Rev Port Cardiol. 1997 May;16(5):443-7, 439.
In 1992, Brugada and Brugada described the "syndrome of right bundle branch block, persistent ST segment elevation and sudden death". This clinical and electrocardiographic entity, which occurs in patients with a structurally normal heart, has drawn the attention of many investigators. Nowadays, the occurrence of sudden death in otherwise asymptomatic patients with a typical ECG, and the transient normalization of the ECG in symptomatic patients, support the existence of asymptomatic and intermittent forms of this disease. The knowledge of these new forms and the modulation of the ECG pattern by administration of antiarrhythmic and autonomic drugs suggest that a functional abnormality of the electrical activity of the heart is responsible for this syndrome. The role of "M cells" in ventricular repolarization and in the occurrence of polymorphic ventricular arrhythmia suggests that these cells are the substrate for that electrical abnormality. Further studies are required to determine the appropriate therapeutic strategy for these patients. Until new information is available, the implantable cardioverter defibrillator is indicated in all symptomatic patients.
1992年，布鲁加达兄弟描述了“右束支传导阻滞、持续性ST段抬高和猝死综合征”。这种临床和心电图表现出现在心脏结构正常的患者中，引起了众多研究者的关注。如今，具有典型心电图的无症状患者发生猝死，以及有症状患者心电图的短暂正常化，都支持了该疾病存在无症状和间歇性形式。对这些新形式的认识以及通过使用抗心律失常药物和自主神经药物对心电图模式的调节表明，心脏电活动的功能异常是该综合征的病因。“M细胞”在心室复极化和多形性室性心律失常发生中的作用表明，这些细胞是该电异常的基础。需要进一步研究以确定针对这些患者的合适治疗策略。在获得新信息之前，所有有症状的患者都应植入心脏复律除颤器。
