Role of Signal-Averaged Electrocardiograms for Predicting the Inducibility of Ventricular Fibrillation in the Syndrome Consisting of Right Bundle Branch Block and ST Segment Elevation in Leads V1-V3.
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- Masaki Riko
- the Second Department of Medicine, Nihon University School of Medicine
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- Watanabe Ichiro
- the Second Department of Medicine, Nihon University School of Medicine
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- Nakai Toshiko
- the Second Department of Medicine, Nihon University School of Medicine
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- Kondo Kazuhiko
- the Second Department of Medicine, Nihon University School of Medicine
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- Oshikawa Naohiro
- the Second Department of Medicine, Nihon University School of Medicine
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- Sugimura Hidezou
- the Second Department of Medicine, Nihon University School of Medicine
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- Okubo Kimie
- the Second Department of Medicine, Nihon University School of Medicine
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- Kojima Toshiaki
- the Second Department of Medicine, Nihon University School of Medicine
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- Saito Satoshi
- the Second Department of Medicine, Nihon University School of Medicine
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- Ozawa Yukio
- the Second Department of Medicine, Nihon University School of Medicine
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- Kanmatsuse Katsuo
- the Second Department of Medicine, Nihon University School of Medicine
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抄録
Right bundle branch block and ST segment elevation (RBBB-STE) in the right precordial leads have been reported as a distinct clinical and electrocardiographic syndrome in patients prone to ventricular fibrillation (VF) in the absence of structural heart disease (Brugada syndrome). The purpose of the study was to investigate the role of signal averaged electrocardiogram (SAECG) in identifying patients at high risk among asymptomatic RBBB-STE patients. Thirteen patients with the RBBB-STE ECG were identified. Symptoms were: syncope (n=3, cases 1, 3, and 11), atypical chest pain (n=3, cases 4, 10, and 12) and palpitations (n=2, cases 6, and 7). The other 5 patients were asymptomatic. SAECG and programmed electrical stimulation (PES) were conducted in all patients. Body surface late potentials (LPs) were present in 7 of 13 patients before PES. Vf was induced in 6 of 7 LP positive patients. Vf was induced in 3 of 6 LP negative patients, but LP became positive in 2 of 3 patients in whom Vf was induced. One patient with syncope due to VF (case 1), 1 patient without symptoms who died suddenly during follow up (case 2), and 1 asymptomatic patient (case 9) showed reproducibly positive LP. In a patient (case 9) with positive LP at baseline, LP transiently became negative during follow up. In RBBB-STE patients, reproducibly positive LP is at risk for malignant ventricular arrhythmias and sudden death. Repeated SAECG recording may be useful for screening high-risk patients who should receive electrophysiological study among asymptomatic RBBB-STE patients.<br>
収録刊行物
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- Ｊａｐａｎｅｓｅ Ｈｅａｒｔ Ｊｏｕｒｎａｌ
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Ｊａｐａｎｅｓｅ Ｈｅａｒｔ Ｊｏｕｒｎａｌ 43 (4), 367-378, 2002
International Heart Journal刊行会