[SCD-FORUM] 30E RE: 无症状性Brugada综合征病人－Perez Riera 医师

[SCD Symposium]

30E RE: 无症状性Brugada综合征病人－Perez Riera 医师

尊敬的Sunil Roy.医师：
你提出的问题是，低电压T波交替对于Brugada综合征的 
危险分层以及决定植入ICD必要性是否有一定作用？

T波交替并非Brugada综合征病人心律失常发生危险的评 
价指标，因此，它不是检测Brugada综合征病人发生心 
律失常危险的合适检查（1）。

Ikeda等人入选了124个具有Brugada综合征型体表心电图表 
现的病人进行连续研究。预后指标包括：年龄、性 
别、猝死家族史、晕厥发作、特发性I型ST段抬高、ST 
段抬高最大值、特发性ST段改变、平均QRSd、QT 间期最 
大值、QT离散度、信号平均心电图中心室晚电位 
（VLP）、T波交替。在12个预后指标中，只有猝死家族 
史、晕厥发作、自发性ST段改变和LP具有显著意义 
（2）。T波交替并不用于心律失常的发生危险评估。

参考文献
1)          Kirchhof P,  Eckardt L,  Rolf S, T wave alternans does not
assess arrhythmic risk in patients with Brugada syndrome.   Ann
Noninvasive Electrocardiol. 2004;9:162-165.20
2)           Ikeda T, Takami M, Sugi K, et al. Noninvasive risk
stratification of subjects with a Brugada-type electrocardiogram and no
history of cardiac arrest. 20
致AndrE9s Ricardo PE9rez Riera20

Chief of Electro-Vectocardiology Sector of the Discipline of
Cardiology,ABC Faculty of Medicine (FMABC), Foundation of ABC (FUABC)-
Santo AndrE9 -SE3o Paulo - Brazil. Rua SebastiE3o Afonso  885 - Zip
Code: 044417-100- Jardim Miriam  S.P.- Brazil - Phone: 5504-6243  Fax:
5506-0398.
Dr. Sergio Dubner
科委会主席

Dr. Edgardo Schapachnik
组委会主席
张欣译  王玲洁校



30E RE: Asymptomatic patient with Brugada syndrome. Dr. Perez Riera

Dear Dr. Sunil Roy.  MD, DM from India. Here Andres Ricardo Perez
Riera. You asked to Ramon Brugada about if is there any role for
microvolt T wave alternans for risk stratifications and to decide the
need for ICD?

T wave alternans (TWA) does not assess arrhythmic risk in patients with
Brugada syndrome (BrS). It is not an appropriate test to detect
arrhythmic risk in patients with BrS (1).

Ikeda et al. enrolled 124 consecutive subjects with a Brugada-type ECG.
Prognostic indices included: age, sex, a family history of SD, syncopal
episodes, a spontaneous Type 1 ST-segment elevation, maximal magnitude
of ST-segment elevation, a spontaneous change in ST segment, a mean
QRSd, maximal QT interval, QT dispersion, LPs by SA-ECG, and TWA. Of the
12 risk indices, only a family history of SD, syncopal episodes, a
spontaneous type 1 ST-segment elevation, a spontaneous change in ST
segment, and LP had significant values (2).TWA does not assess
arrhythmic risk

References
1)          Kirchhof P,  Eckardt L,  Rolf S, T wave alternans does not
assess arrhythmic risk in patients with Brugada syndrome.   Ann
Noninvasive Electrocardiol. 2004;9:162-165.20
2)           Ikeda T, Takami M, Sugi K, et al. Noninvasive risk
stratification of subjects with a Brugada-type electrocardiogram and no
history of cardiac arrest. 20
All the best
AndrE9s Ricardo PE9rez Riera20
Chief of Electro-Vectocardiology Sector of the Discipline of
Cardiology,ABC Faculty of Medicine (FMABC), Foundation of ABC (FUABC)-
Santo AndrE9 -SE3o Paulo - Brazil. Rua SebastiE3o Afonso  885 - Zip
Code: 044417-100- Jardim Miriam  S.P.- Brazil - Phone: 5504-6243  Fax:
5506-0398.

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee