目的Ⅱ型Brugada综合征和不完全性右束支传导阻滞(IRBBB)的心电图表现类似,V1导联均呈r Sr’型,但是它们的发病机制和治疗方法、预后完全不同,本研究试图发现二者在心电图指标的不同,以期减少Ⅱ型Brugada综合征早期就诊时的漏诊和误诊...目的Ⅱ型Brugada综合征和不完全性右束支传导阻滞(IRBBB)的心电图表现类似,V1导联均呈r Sr’型,但是它们的发病机制和治疗方法、预后完全不同,本研究试图发现二者在心电图指标的不同,以期减少Ⅱ型Brugada综合征早期就诊时的漏诊和误诊。方法选择心电图诊断为IRBBB的心电图146例,根据ST段形态将其分为:(1)ST段抬高组,分为两个亚组:①马鞍形ST段抬高组,也即Ⅱ型Brugada综合征样心电图改变(21例);②非马鞍形ST段抬高组,也即IRBBB伴ST段抬高,(28例);(2)非ST段抬高组,也即IRBBB不伴ST段抬高(97例),观察V1/V2S波上升肢与r’(或J波)下降肢之间的夹角(β角),经r’顶点(或J波顶点)的垂直线与r’下降肢(或J波下降肢)之间的夹角(α角)以及β角与基线形成的基底的长度,与β角顶点5mm垂直线相交的基底线的长度。结果①ST段抬高组α角以及β角显著大于无ST段抬高组(17.9±9.2 vs 15.5±7.1,p<0.01,23.3±10.3 vs 20.8±9.0,p<0.05);②Ⅱ型Brugada心电图样改变组α角以及β角显著大于IRBBB伴ST段抬高组,(20.7±10.1 vs 15.8±7.2,p<0.05,25.6±11.3 vs 20.8±9.0,p<0.05)。结论 ST段抬高的形态与α角以及β角有关,马鞍型的ST段抬高的α角以及β角明显增大,可以此作为诊断和鉴别诊断Ⅱ型Brugada样心电图改变与不完全性右束支阻滞的客观依据之一。展开更多
Background We have discovered an unexpected phenomenon that patients with malignant tumor （MT） were commonly associated with type I Brugada-like wave on electrocardiogram（ECG）. Methods For a retro- spective study,...Background We have discovered an unexpected phenomenon that patients with malignant tumor （MT） were commonly associated with type I Brugada-like wave on electrocardiogram（ECG）. Methods For a retro- spective study, we collected the clinical history, demographic data, laboratory examinations, imaging docu- ments and medication information of 22 patients with type I Brugada-like wave. Results Of 22 patients with type I Brugada-like wave, five suffered from MT, accounting for 22.7%. Of the 5 MT patients, two had nor- mal ECG when diagnosis was made, displayed Brugada-like wave during the chemotherapy of anti-neoplastic drug. After appearing, Brugada-like wave would continuously exist during the course of chemotherapy. The longest existing time of Brugada-like wave lasted over five years. The two patients had no compression of right ventricular outflow tract（RVOT）, no electrolyte abnormality and no use of the known drugs being able to in- duce Brugada-like wave, such as class I anti-arrhythmic drugs. Conclusion Anti-neoplastic drug is a new factor being able to induce Brugada-like wave.展开更多
文摘目的Ⅱ型Brugada综合征和不完全性右束支传导阻滞(IRBBB)的心电图表现类似,V1导联均呈r Sr’型,但是它们的发病机制和治疗方法、预后完全不同,本研究试图发现二者在心电图指标的不同,以期减少Ⅱ型Brugada综合征早期就诊时的漏诊和误诊。方法选择心电图诊断为IRBBB的心电图146例,根据ST段形态将其分为:(1)ST段抬高组,分为两个亚组:①马鞍形ST段抬高组,也即Ⅱ型Brugada综合征样心电图改变(21例);②非马鞍形ST段抬高组,也即IRBBB伴ST段抬高,(28例);(2)非ST段抬高组,也即IRBBB不伴ST段抬高(97例),观察V1/V2S波上升肢与r’(或J波)下降肢之间的夹角(β角),经r’顶点(或J波顶点)的垂直线与r’下降肢(或J波下降肢)之间的夹角(α角)以及β角与基线形成的基底的长度,与β角顶点5mm垂直线相交的基底线的长度。结果①ST段抬高组α角以及β角显著大于无ST段抬高组(17.9±9.2 vs 15.5±7.1,p<0.01,23.3±10.3 vs 20.8±9.0,p<0.05);②Ⅱ型Brugada心电图样改变组α角以及β角显著大于IRBBB伴ST段抬高组,(20.7±10.1 vs 15.8±7.2,p<0.05,25.6±11.3 vs 20.8±9.0,p<0.05)。结论 ST段抬高的形态与α角以及β角有关,马鞍型的ST段抬高的α角以及β角明显增大,可以此作为诊断和鉴别诊断Ⅱ型Brugada样心电图改变与不完全性右束支阻滞的客观依据之一。
文摘Background We have discovered an unexpected phenomenon that patients with malignant tumor （MT） were commonly associated with type I Brugada-like wave on electrocardiogram（ECG）. Methods For a retro- spective study, we collected the clinical history, demographic data, laboratory examinations, imaging docu- ments and medication information of 22 patients with type I Brugada-like wave. Results Of 22 patients with type I Brugada-like wave, five suffered from MT, accounting for 22.7%. Of the 5 MT patients, two had nor- mal ECG when diagnosis was made, displayed Brugada-like wave during the chemotherapy of anti-neoplastic drug. After appearing, Brugada-like wave would continuously exist during the course of chemotherapy. The longest existing time of Brugada-like wave lasted over five years. The two patients had no compression of right ventricular outflow tract（RVOT）, no electrolyte abnormality and no use of the known drugs being able to in- duce Brugada-like wave, such as class I anti-arrhythmic drugs. Conclusion Anti-neoplastic drug is a new factor being able to induce Brugada-like wave.
