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Brugada-syndroom: verschil tussen versies
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== | ==Electrocardiographic criteria== | ||
Three ECG repolarization patterns in the right precordial leads are recognized in the diagnosis of Brugada syndrome. | |||
'''Type I''' is the only ECG criterium that is diagnostic of Brugada syndrome. Type I repolarization is characterized by a coved ST-segment elevation >=2 mm (0.2 mV) followed by a negative T wave (see figure). Brugada syndrome is definitively diagnosed when a type 1 ST-segment elevation is observed in >1 right precordial lead (V1 to V3) in the presence or absence of a sodium channel–blocking agent, and in conjunction with one of the following: | |||
*documented ventricular fibrillation (VF) | |||
*polymorphic ventricular tachycardia (VT) | |||
*a family history of sudden cardiac death at <45 years old | |||
*coved-type ECGs in family members | |||
*inducibility of VT with programmed electrical stimulation | |||
*syncope | |||
*nocturnal agonal respiration. | |||
Electrocardiograms of Brugada patients can change over time from type I to type II ECGs and back. | |||
A type III ECG is rather common and is concidered a normal variant. | |||
{| class="wikitable" font-size="90%" | |||
|- style="text-align:center;background-color:#6EB4EB;" | |||
|+'''ST segment abnormalities in the different types of Brugada syndrome'''<cite>Wilde2</cite> | |||
|- | |||
! | |||
!Type I | |||
!Type II | |||
!Type III | |||
|- | |||
!J wave amplitude | |||
|>= 2mm | |||
|>= 2mm | |||
|>= 2mm | |||
|- | |||
!T wave | |||
|negative | |||
|positive or biphasis | |||
|positive | |||
|- | |||
!ST-T configuration | |||
|coved type | |||
|saddleback | |||
|saddleback | |||
|- | |||
!ST segment (terminal portion) | |||
|gradually descending | |||
|elevated >= 1mm | |||
|elevated < 1mm | |||
|- | |||
|} | |||
<gallery caption="Examples of Brugada syndrome type I"> | |||
Image:Brugada_syndrome_type1_example1.png | |||
Image:Brugada_syndrome_type1_example2.png | |||
Image:Brugada_syndrome_type1_example3.png | |||
Image:Brugada_syndrome_type1_example4.png | |||
Image:Brugada_syndrome_type1_example5.png | |||
</gallery> | |||
<gallery caption="Examples of Brugada syndrome type II"> | |||
Image:Brugada_syndrome_type2_example1.png | |||
</gallery> | |||
==Diagnose en behandeling== | ==Diagnose en behandeling== | ||