普罗帕酮试验引起Brugada综合征心室颤动(附一例报告)

探索普罗帕酮试验在Brugada综合征中的作用及安全性。患者有家族性夜间猝死史 ,近 1 9个月来反复发作性夜间晕厥5次 ,两次猝死未遂 ,一次记录到的心电图为心室颤动 (VF) ,其超声心动图、冠状动脉造影、左右心室造影正常 ,电生理检查心脏传导系统功能正常 ,右心室程序电刺激可诱发VF ,诊断不明。静脉用普罗帕酮 2mg/kg后 30min出现典型Brugada综合征心电图改变 ,并诱发VF。结论 :普罗帕酮可作为诊断Brugada综合征的工具 ,同时应警惕其致心律失常作用

The Propafenone Challenge Provoked Ventricular Fibrillation in A Patient With Brugada Syndrome

To identify the diagnostic impact and safety of the propafenone in Brugada syndrome. A patient with the family history of nocturnal sudden cardiac death experienced five times syncope and two times aborted sudden cardiac death during last 19 months. The ventricular fibrillation (VF) was documented in one syncope episode. His coronary arteries were normal by the angiogram. The echocardiography and ventriculography showed normal structurally heart. The AH and HV intervals was normal. The VF was induced by the programmed stimulation in the right ventricular apex. The diagnosis could not be made from his history and above work ups. The propafenone challenge (2 mg/kg) demonstrated the typical Brugada ECG change and provoked the VF in 30 minutes after intravenous.Conclusions: The propafenone challenge could unmask the concealed Brugada syndrome. Proarrhythmic effects of the drug should be cautious.