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目的运用Holter和置入式心脏复律除颤器(ICD)研究Brugada综合征(BrS)患者室性心律失常发作的时间特征。方法8例BrS患者和6例特发性BrS心电图征者均为男性,平均年龄(41.07±11.49)岁,根据临床表现分为心室颤动(室颤)组和无室颤组各7例,行Holter检查比较两组间室性早搏(室早)发作的时间特征。根据ICD的随访资料,分析室颤发作的时间特征。结果Holter显示,多数患者室早总数在0~74(9.61±17.23)个/24h,两组间室早的数量差异无统计学意义[(108±269)个/24h与(8±19)个/24h,P>0.05]。室颤组的98.67%的室早发作集中在夜间2200至凌晨700,而无室颤组为44.14%,室颤组明显高于无室颤组(χ2=1480,P<0.01)。5例患者ICD置入后随访9~54(23.80±17.96)个月,75次室颤发作中93.3%集中在夜间2200至凌晨700。结论高危的BrS患者的室早具有夜间和凌晨集中发作的特征,可能是新的无创性危险分层指标。BrS患者的室颤发作多集中在夜间和凌晨,可据此设计给药方案以减少副作用。
Objective To study the temporal characteristics of ventricular arrhythmias in patients with Brugada syndrome (BrS) using Holter and cardioverter defibrillator (ICD). Methods Eight patients with BrS and 6 patients with idiopathic BrS ECG were male, mean age (41.07 ± 11.49) years. According to the clinical manifestations, they were divided into seven groups: ventricular fibrillation (VF) group and no VF group The Holter test compared the time characteristics of premature ventricular contractions (ventricular premature beats) between the two groups. According to the ICD follow-up data, analysis of the time characteristics of ventricular fibrillation. Results Holter showed that the majority of patients had an early total number of 0 to 74 (9.61 ± 17.23) / 24h, with no significant difference between the two groups (108 ± 269) / 24h and (8 ± 19) /24h,P>0.05]. The premature ventricular seizures occurred in 98.67% of the patients in the VF group from 2200 to 700 in the night, 44.14% in the VF group, and significantly higher in the VF group than those in the VF group (χ2 = 1480, P <0.01). Five patients were followed up for 9-54 (23.80 ± 17.96) months after ICD implantation. 93.3% of 75 episodes of VF were concentrated at night from 2200 to 700 in the morning. Conclusion Patients with high-risk BrS may have nocturnal and early-morning intensive episodes and may be a new noninvasive risk stratification index. The incidence of ventricular fibrillation in patients with BrS is more concentrated in the night and early morning, according to which the dosing regimen can be designed to reduce the side effects.