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El sustrato electrofisiológico cardíaco subyacente al fenotipo del ECG y las anomalías del electrograma en pacientes

Junjie Zhang¹, Frédéric Sacher¹, Kurt Hoffmayer¹

¹From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Haïssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine, Washington University, St. Louis, MO (P.C., J.S., D.C., M.F., Y.R.); and School of Medicine, University of California, San Francisco (M. Scheinman).

|March 27, 2015

Resumen

El síndrome de Brugada (BrS) implica una actividad eléctrica anormal en el ventrículo derecho, causando un retraso en la conducción y la repolarización. Las imágenes de ECG pueden distinguir BrS de otras afecciones cardíacas.

Área de la Ciencia:

Cardiología Cardiología.
Electrofisiología y electrofisiología.
Imágenes médicas de imágenes médicas.

Sus antecedentes:

El síndrome de Brugada (BrS) es un trastorno cardíaco relacionado con la muerte súbita.
Las anomalías eléctricas específicas que causan BrS en el corazón no se comprenden completamente.

Objetivo del estudio:

Para caracterizar el sustrato electrofisiológico del síndrome de Brugada utilizando imágenes de ECG no invasivas.
Para diferenciar las propiedades eléctricas de BrS del bloque de ramo de mano derecha.

Principales métodos:

Utilizó imágenes no invasivas de ECG en 25 pacientes con BrS, 6 con bloqueo de la rama del haz derecho y 7 controles sanos.
Se analizaron electrogramas unipolares, tiempos de activación, propiedades de conducción e intervalos de repolarización.

Principales resultados:

Los pacientes con BrS mostraron anormalidades exclusivamente en el tracto de flujo ventricular derecho, incluida la elevación del segmento ST y la activación retardada.
Se caracteriza por electrogramas fraccionados de baja amplitud que indican una conducción discontinua lenta y una repolarización retrasada.
Gradientes de repolarización pronunciados en los límites del tracto de salida ventricular derecha en pacientes con BrS.

Conclusiones:

La conducción discontinua lenta y la dispersión de repolarización escarpada son características clave del tracto de flujo de salida del ventrículo derecho en BrS.
Las imágenes de ECG distinguen efectivamente el síndrome de Brugada del bloqueo de la rama del haz derecho basado en distintos sustratos electrofisiológicos.

Palabras clave:

El síndrome de Brugada es el síndrome de Brugada.La electrocardiografía es una electrocardiografía.electrofisiología electrofisiología.

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