早期复极综合征的研究进展

Advance in Early Repolarization Syndrome

早期复极综合征(ERS)可能与心脏性猝死密切相关,其机制可能与心外膜瞬时外向钾离子流介导的动作电位复极不一致有关。ERS危险因素包括有晕厥、猝死及室性心律失常史、下侧壁导联J点抬高超过0.2 mV或J波广泛分布、心室除极异常、急性心肌梗死、特异性基因突变等。目前仍无完全有效预防ERS相关的恶性心律失常的药物或非药物。药物治疗中的奎尼丁及异丙肾上腺素可能有效,但需要进一步证实。埋藏式心脏转复除颤器是目前唯一被证实对预防ERS高危患者心室纤颤的有效办法。

It is known that early repolarization syndrome（ERS） may be closely related to the cardiac sudden death,so further understanding of the mechanism,risk stratification and treatment is necessary. The mechanism is not clear,which might be associated with inconsistent action potential repolarization mediated by epicardial transient outward potassium ion flow. ERS risk factors include syncope,sudden death and ventricular arrhythmia history,inferolateral leads J point elevation of more than 0.2 mV or J wave wide distribution,ventricular depolarization abnormalities,acute myocardial infarction,and specific gene mutation etc. There is no medicine or non-pharmaceutical therapy to prevent ERS related malignant arrhythmia. Quinidine and isoproterenol in drug therapy may be effective,but need further confirmation. Implantable cardioverter-defibrillator therapy is the only method confirmed to be effective for preventing ventricular fibrillation for high risk ERS patients.