异常J波、Brugada综合征与特发性Brugada心电图征的临床与心电图特征

The Clinical and Electrocardiographic Character of Abnormal J Wave and Brugada′s Syndrome or Electrocardiogram Sign of Idiopathic Brugada′s

对比分析异常J波 2 1例、Brugada综合征 8例与特发性Brugada心电图征 11例的临床及心电学特点。结果 :①特发性异常J波在肢导联或 (和 )胸导联可见正向异常J波 [除aVR(部分患者aVL)外 ],其波幅较低而分布较广 ,一般V1～V2 导联不出现J波 ,若出现则JV1 ～V2<R ,不伴右束支组滞 (RBBB) ,TV1 ～V3常直立 ;继发性异常J波有明确的原发病 ,其异常J波的波幅更高大、分布更广泛 ,常伴有QTmin、QTmax、STmax延长 ;两者均易诱发多形性室性心动过速及 /或心室颤动而致死。②Brugada综合征及特发性Brugada心电图征在V1～V3 导联ST段呈下斜或马鞍型抬高伴RBBB或类RBBB ,R′>R ,TV1 ～V2 (V3) 倒置或直立 ,前者常出现恶性快速性室性心律失常而发生晕厥或猝死 ,后者则无晕厥或猝死及恶性心律失常发作。结论 :异常J波和Brugada综合征及特发性Brugada心电图征是具有不同临床及心电学特点的临床实体。

We investigated the clinical and electrocardiographic character of 21 cases with the abnormal J wave,8 cases with the Brugada′s syndrome,and 11 cases with the electrocardiogram sign of idiopathic Brugada′s. Results: ①Except in lead aVR(aVL in a part patients), there were upright abnormal J wave in limb or(and) precordal leads in idiopathic and secondary abnormal J wave. The J waves were significantly lower and distributived extensiver in idiopathic abnormal J wave than those in Brugada′s syndrome and electrocardiogram sign of idiopathic Brugada′s. There was not J waves generally in leads V 1～V 2, if it had , which were smaller than those R waves.The T waves often was upright and without right bundle branch block(RBBB) in leads V 1～V 3. There was explicit etiology in secondary abnormal J wave, their J waves were significantly higher and distributived extensiver and that also had longer QTmin、QTmax、STmax than those in idiopathic abnormal J wave ,the Brugada′s syndrome,and the electrocardiogram sign of idiopathic Brugada′s. In both instances polymorphic ventricular tachycardia and ventricular fibrillation were more often induced and led to death. ②The ST segment was elevation of slanting type or saddle type with RBBB or similar RBBB in the Brugada′s syndrome and the electrocardiogram sign of idiopathic Brugada′s . Their R′ waves was higher than R waves in leads V 1～V 3, T waves often was inversion or upright in leads V 1～V 3.The former appeared usually sudden cardiac death or cardiac syncope by malignant rapid ventricular arrhythmia and the latter had not. Conclusion: The idiopathic and secondary abnormal J wave are different from the Brugada′s syndrome and the electrocardiogram sign of idiopathic Brugada′s in clinical and electrocardiographic character.