[SCD-FORUM] 72S RE:阵发性房颤复律后心电图Brugada综合征表现――阿根廷 Rondon医师、Silvano Diangelo医师

[SCD Symposium]

72S RE:阵发性房颤复律后心电图Brugada综合征表现―― 
阿根廷 Rondon医师、Silvano Diangelo医师
尊敬的的医师：
我斗胆就这一病例发表一点看法。以前，我曾经收治 
过6个具有Brugada心电图表现的男孩，其中1例由运动诱 
发，2例由药物诱发，另外3例表现为自发性，这些病 
人信号平均心电描计仪上有晚期电位，心超检查示左 
室功能正常。我认为，利用电生理检查诱发恶性心律 
失常的准确性非常重要，即使在不可能诱发出持续性 
室速的患者中也是如此。
我认为如果患者具有以下分层条件：
每次发作时均有Brugada综合征图形；信号平均心电描 
计仪上有晚期电位；电生理检查诱发出持续性恶性心 
律失常；
则该患者应该接受植入ICD的保护。尽管我很清楚要求 
无症状性病人接受这一治疗措施并非易事，但是这一 
做法的目的是避免病人出现心脏猝死，这可能是唯一 
且最后的心律失常表现。
委内瑞拉－加拉卡斯
―――
Sergio Dubner 医师
科委会主席
Edgardo Schapachnik医师
组委会主席
张欣译 王玲洁校
72S RE: Brugada pattern post-PAF reversion. Dr. Rondon Dr. Silvano  
Diangelo Argentina
Dear Dr.
I dare to express an opinion about this case, because I have had 6
cases of young boys with Brugada pattern, 1 triggered by exercise, 2
triggered by drugs, and 3 with spontaneous expression, who were   
studied with SA-ECG, with presence of late potentials and   
echocardiographic evaluation with maintained LV function. I think the
EPS is very important to be accurate about malignant arrhythmia
induction, even when there are cases in which it is not possible to
induce sustained VT.
I think that a patient with stratification of:
Brugada pattern in any of its manifestations
With SA-ECG with evidence of late potentials
Evidence in EPS of sustained malignant arrhythmia induction.

Should go to protection with ICD, even when I am well aware that it
is not easy to implant a system in asymptomatic patients; but the
idea is to protect them from SCD events, which could be the only and
last arrhythmic manifestation in this patient.
Caracas - Venezuela

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee