Atrial Electrophysiological Abnormality in Patients With Brugada Syndrome Assessed by P-Wave Signal-Averaged ECG and Programmed Atrial Stimulation

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概要

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• Background There is evidence that some patients with Brugada syndrome (BS) exhibit atrial tachyarrhythmias including paroxysmal atrial fibrillation. We investigated whether BS associated not only with vulnerability to ventricular fibrillation, but also with vulnerability to atrial fibrillation. Methods and Results In 15 patients with BS and Brugada-type electrocardiogram (ECG) (14 men, 1 woman; age 52.8±12.9 years) and 15 age-matched control patients (12 men, 3 women; age 50.9±18.9 years), the P-wave signal-averaged ECG was recorded, and the filtered P-wave duration was derived from the vector magnitude obtained by X, Y, Z leads. In 11 of the 15 patients with BS and Brugada-type ECG, invasive electrophysiologic testing was conducted. Filtered P-wave duration was significantly increased in patients with BS and Brugadatype ECG in comparison with control subjects (143.2±12.9 vs 129.6±10.1 ms, p<0.001). Ventricular late potential (root mean square voltage <20μV in the last 40 ms and <40μV at a low amplitude signal duration >38ms) was present in 10 of the 12 BS patients in whom a QRS wave signal-averaged electrogram was also recorded. In all 11 patients with Brugada-type ECG who underwent electrophysiologic testing, sustained atrial fibrillation (>5 min) was induced by 1 or 2 atrial extrastimuli. In 10 of these 11 patients, ventricular fibrillation was also induced by 2 or 3 right ventricular extrastimuli. Conclusions The electrical abnormality in BS is not limited to the ventricular level; similar changes occur in the atria. Such abnormal conduction properties could be a substrate for re-entrant atrial tachyarrhythmias.

• 社団法人日本循環器学会の論文
• 2006-11-20

著者

• SHINDO Atsushi

  Department of Neurological Surgery, Kagawa University Faculty of Medicine

• HASHIMOTO Kenichi

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• WATANABE Ichiro

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• OKUMURA Yasuo

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• TAKAGI Yasuhiro

  Departments of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine

• YAMADA Takeshi

  Department of Cardiology, Kouseikai Takeda Hospital

• Saito satoshi

  Department of Medicine, Division of Cardiovascular Medicine, Nihon University School of Medicine

• Sato Sumiko

  Ehime Prefectural Central Hospital

• 中山 智祥

  Department Of Cardiovascular Renal And Endocrine Medicines Research Center And Cardiovascular Functi

• Takagi Yasuhiro

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Kasamaki Yuji

  Department of Cardiology, Nihon University School of Medicine

• Watanabe Ichiro

  Department of Cardiology, Nihon University School of Medicine

• Watanabe Ichiro

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Nakai Toshiko

  Department Of Cardiovascular Renal And Endocrine Medicines Research Center And Cardiovascular Functi

• HASHIMOTO Kenichi

  Department of Physics,Tokyo Metropolitan University

• Hashimoto Kenichi

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Kasamaki Yuji

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• OKUMURA Yasuo

  Department of Chemical Engineering and Materials Science, Faculty of Engineering, Doshisha Universit

• Yamada Takeshi

  Division of cardiology, Department of Medicine, Nihon University School of Medicine

• Tamura Yasuo

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• KASAMAKI Yuji

  Div. of Cardiovascular Med. Nihon Univ. Sch. of Med

• Shindo Atsushi

  Division Of Cardiovascular Medicine Nihon University School Of Medicine

• Shindo Atsushi

  Department Of Neurological Surgery Kagawa University Faculty Of Medicine

• Okubo Kimie

  Department of Cardiology, Nihon University School of Medicine

• Takagi Yasuhiro

  Department Of Biotechnology Graduate School Of Engineering Osaka University

• Yamada T

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Shindo Atsushi

  Division Of Cardiology Nihon University School Of Medicine

• Okumura Yasuo

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Okumura Yasuo

  Department Of Chemical Engineering And Materials Science Faculty Of Engineering Doshisha University

• Shindo Atsushi

  Second Department Of Internal Medicine Nihon University School Of Medicine

• Nakayama Tomohiro

  Division Of Receptor Biology Advanced Medical Research Center Nihon University School Of Medicine

• Ohkubo Kimie

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Kasamaki Yuji

  Department Of Cardiology Nihon University School Of Medicine

• Nakajima Teruo

  Second Department Of Internal Medicine Nihon University School Of Medicine

• Okubo Kimie

  Department Of Cardiology Nihon University School Of Medicine

• Takagi Yasuhiro

  The Second Department Of Medicine Nihon University Shool Of Medicine

• Saito Satoshi

  Department Of Advanced Medical Science Nihon University School Of Medicine

• Shindoh Atsushi

  Second Department Of Internal Medicine Nihon University School Of Medicine

• Takagi Yasuhiro

  Department Of Applied Chemistry Tokyo University Of Agriculture And Technology

• Nakayama Tomohiro

  Division Of Molecular Diagnostics Advanced Medical Research Center Nihon University School Of Medici

• Yasugi Tadao

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Takagi Yasuhiro

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Yamada Takeshi

  Department Of Anesthesiology Iida Municipal Hospital

• Okumura Yasuo

  Department Of Cardiology Nagoya Graduate School Of Medicine

• Hashimoto Kenichi

  Department of Neurology, Dokkyo Medical University, Japan

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