ブルガダ症候群は,完全な右束枝ブロックの背後にある.
Yoshiyasu Aizawa1, Seiji Takatsuki, Motoaki Sano
1Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan. yoshiyaaizawa-circ@umin.ac.jp.
Circulation
|August 2, 2013
まとめ
完全右束枝ブロック (CRBBB) は,ブルガダ症候群 (BS) を心電図に隠すことができる. BSの診断は,ブロックが存在する場合でも,CRBBB解像度または特定のSTセグメントの変化で可能です.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 医療診断 医療診断
背景:
- ブルガダ症候群 (BS) は,特徴的なECGの発見を示しています.
- コンプリート・レイト・バンドル・ブランチ・ブロック (CRBBB) は,これらのBS ECGパターンを遮る可能性があります.
- BSとCRBBBが共存すると,診断上の課題が生じます.
研究 の 目的:
- ブルガダ症候群 (BS) と完全右束枝ブロック (CRBBB) の共存を調査する.
- CRBBBによってマスクされたBSを診断する方法を決定する.
- 両方の疾患を有する患者のECG特性を分析する.
主な方法:
- 研究には,BSとCRBBBの両方と診断された11人の患者が含まれていました.
- BS診断は,CRBBB以前に,その解消時に,または新しいSTセグメントの変更を通じて確立されました.
- 構造的な心臓病と冠動脈の排除が行われました.
- QRSの持続時間とSTセグメントの上昇を含むEKGのパラメータを分析し,対照と比較した.
主要な成果:
- BSは,CRBBBの発症前に7人の患者に診断されました.
- CRBBB解像度 (自発的またはペースによって誘発された) は,4人の患者でBS診断を助けました.
- BSを示す新しいSTセグメントの上昇は3人の患者で観察され,2人の患者で薬によって誘発されました.
- BSとCRBBBの患者は,対照群と比較して,QRSの持続期間が著しく延長されたことを示しました.
結論:
- コンプリート・ライト・バンドル・ブランチ・ブロック (CRBBB) は,ブルガダ症候群 (BS) を効果的にマスクすることができます.
- BSの診断は,CRBBB解像度または特定のSTセグメントの変更によって実現可能である.
- 併用CRBBBとBSの有病率,メカニズム,および臨床的重要性を理解するためにさらなる研究が必要である.
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