循環器ジャーナル69巻2号

2021年04月発行

特集 エキスパートに学ぶ 知っておきたい心電図診断のコツと落とし穴 不整脈

Brugada症候群

著者： 深田光敬¹ 丸山徹²

所属機関： ¹九州大学病院血液・腫瘍・心血管内科（ハートセンター） ²九州大学キャンパスライフ・健康支援センター

ページ範囲：P.287 - P.294

Point
・診断的意義のあるcoved型心電図は，QRS終末部からhigh-take offを示し，上に凸もしくは直線的にST部分が上昇し，陰性T波へ移行する．
・Brugada phenocopyを示す疾患について知り，Corrado indexなどの指標を用いることが鑑別に有用である．

参考文献

1) Brugada P, Brugada J:Right bundle branch block, persistent ST segment elevation and sudden cardiac death:a distinct clinical and electrocardiographic syndrome. A multicenter report. J Am Coll Cardiol 20:1391-1396, 1992

2) Antzelevitch C:The Brugada syndrome:ionic basis and arrhythmia mechanisms. J Cardiovasc Electrophysiol 12:268-272, 2001

3) Veerakul G, Nademanee K:Brugada syndrome:two decades of progress. Circ J 76:2713-2722, 2012

4) Antzelevitch C, Brugada P, Borggrefe M, et al:Brugada syndrome:report of the second consensus conference:endorsed by the Heart Rhythm Society and the European Heart Rhythm Association. Circulation 111:659-670, 2005

5) de Luna AB, Brugada J, Baranchuk A, et al:Current electrocardiographic criteria for diagnosis of Brugada pattern:a consensus report. J Electrocardiol 45:433-442, 2012

6) Hisamatsu K, Morita H, Kusano KF, et al:Evaluation of the usefulness of recording the ECG in the 3rd intercostal space and prevalence of Brugada-type ECG in accordance with recently established electrocardiographic criteria. Circ J 68:135-138, 2004

7) Miyazaki T, Mitamura H, Miyoshi S, et al:Autonomic and antiarrhythmic drug modulation of ST segment elevation in patients with Brugada syndrome. J Am Coll Cardiol 27:1061-1070, 1996

8) Nakazawa K, Sakurai T, Takagi A, et al:Autonomic imbalance as a property of symptomatic Brugada syndrome. Circ J 67:511-514, 2003

9) Makimoto H, Nakagawa E, Takaki H, et al:Augmented ST-segment elevation during recovery from exercise predicts cardiac events in patients with Brugada syndrome. J Am Coll Cardiol 56:1576-1584, 2010

10) Ikeda T, Abe A, Yusu S, et al:The full stomach test as a novel diagnostic technique for identifying patients at risk of Brugada syndrome. J Cardiovasc Electrophysiol 17:602-607, 2006

11) Nogami A, Nakao M, Kubota S, et al:Enhancement of J-ST-segment elevation by the glucose and insulin test in Brugada syndrome. Pacing Clin Electrophysiol 26:332-337, 2003

12) Maglione TJ, Aboyme A, Ghosh BD, et al:Electrical storm in a febrile patient with Brugada syndrome and COVID-19 infection. HeartRhythm Case Rep 6:676-679, 2020

13) Mizusawa Y, Morita H, Adler A, et al:Prognostic significance of fever-induced Brugada syndrome. Heart Rhythm 13:1515-1520, 2016

14) Dumaine R, Towbin JA, Brugada P, et al:Ionic mechanisms responsible for the electrocardiographic phenotype of the Brugada syndrome are temperature dependent. Circ Res 85:803-809, 1999

15) Corrado D, Pelliccia A, Heidbuchel H, et al:Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J 31:243-259, 2010

16) 日本循環器学会，他：遺伝性不整脈の診療に関するガイドライン（2017年改訂版）．2018

17) Antzelevitch C, Yan GX, Ackerman MJ, et al:J-Wave syndromes expert consensus conference report:Emerging concepts and gaps in knowledge. J Arrhythm 32:315-339, 2016

18) Baranchuk A, Nguyen T, Ryu MH, et al:Brugada phenocopy:new terminology and proposed classification. Ann Noninvasive Electrocardiol 17:299-314, 2012

19) Antzelevitch C, Yan GX:J wave syndromes. Heart Rhythm 7:549-558, 2010

20) Yasuda S, Kokawa Y, Nakamura H, et al:A case of Brugada syndrome associated with inferolateral early repolarization presenting idiopathic ventricular fibrillation. Jpn J Electrocardiology 31:476-484, 2011