J波与J波综合征

Latest progress in electrocardiographic J wave and J wave syndrome

早期复极综合征、Brugada综合征、变异型Brugada综合征(包括"下壁导联有明显J波的心脏性猝死","下壁导联有明显J波及ST段下斜型抬高的原发性室颤")的离子及细胞学机制相似,被称为Ito电流调节的"J波综合征",它们之间的区别仅在于Ito电流密度及J波大小。Ito电流密度及J波大小在诱发心律失常中起重要作用。Brugada综合征时V1～V3导联出现J波及ST抬高,发生心脏性猝死的危险性高;而早期复极综合征时V4～V6导联出现J波及ST抬高,一般认为是良性的。换句话说,累及右室的J波可能致心律失常,累及左室前侧壁的J波常是良性的,而累及左室下壁的明显J波及ST抬高对检出既往不明原因晕厥患者处于心脏性猝死的高危状态具有诊断意义。

Early repolarization syndrome, Brugada syndrome and Brugada syndrome variant （including sudden cardiac death associated with a prominent J waves in the inferior leads and ventricular fibrillation associated with a prominent J waves and ST segment elevation in the inferior leads） are identical in terms of their ionic and cytological mechanism and may be referred to an Ito-mediated J-wave syndrome. The only difference among these clinical entities is the difference in Ito densities and associated J wave sizes. Ito densities and wave sizes play a key role in arrhythmogenesis. In the leads V1 - V3, the J wave and ST segment elevation are the signs that indicate a high risk of sudden cardiac death,i, e. ,the Brugada syndrome. In contrast,the J wave and ST segment elevation in V4 - V6 is generally considered to be benign, i. e. , the early repolarization syndrome. In other words, J wave that involve the right ventricle are arrhythmogenic;those that involve the left ventricular anterolateral regions are generally benign. Prominent J waves and ST segment elevation involve the left ventricular inferior wall may serve as an important diagnostic sign to detect high risk individuals with a history of unexplained syncope in the condition of sudden cardiac death.