高位右侧胸前导联对诊断Brugada综合征心电图的价值

Utility of right precordial leads at higher intercostals space to diagnose Brugada syndrome

目的观察加做高位右侧胸前导联对揭示Brugada综合征心电图的有效性。方法对有猝死家族史、心电图胸前导联ST段抬高的3例患者进行家系调查,对3个家系中的10个成员进行了体格检查、X线胸片、超声心动图检查,将30例20～50岁的健康体检者作为对照,描记常规及高位右侧胸前导联心电图。结果加做高位右侧胸前导联可提高Brugada综合征心电图诊断的阳性率,且极为简便、安全。结论与常规心电图相比高位右侧胸前导联心电图能有效地提高Brugada综合征心电图诊断的阳性率。

Objective The effect of right precordial leads at higher intercostals space to diagnose Brugada syndrome were evaluated.Methods Ten persons from 3 different families (group A) who have positive family history of sudden death were submitted to extensive evaluations,including history inquiry,physical examination,and echocardiography.Thirty persons without organic heart diseases of 20～50 years old were taken as controls(group B).A standard electrocardiogram was recorded in 4th,3rd and 2nd intercostals space in right precordium on all subjects (group A and B). Result Recording the electrocardiogram of right precordial leads at higher intercostals space safely and expediently unmasked or accentuated the J-ST elevation in Brugada syndrome.Conclusion It is useful to take the electrocardiogram with the exploring electrode placed at 1～2 intercostal spaces higher than routine electrocardiography for the purpose of unmasking signs of Brugada syndrome.