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2012, Número 2

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Rev Cubana Invest Bioméd 2012; 31 (2)


Actualización sobre el manejo de los pacientes con el patrón electrocardiográfico del síndrome de Brugada

Castro HJA

Idioma: Español
Referencias bibliográficas: 46
Paginas: 175-186
Archivo PDF: 465.03 Kb.


RESUMEN

El síndrome de Brugada es una canalopatía que causa entre el 4 -12 % de todas las muertes súbitas de origen cardíaco y el 20 % de aquellos con "corazón sano''. Es un síndrome clínico-electrocardiográfico, caracterizado por un patrón convexo en el electrocardiograma en al menos 2 derivaciones precordiales derechas y tendencia a presentar síncopes y/o parada cardíaca causados por taquicardia ventricular polimórfica y/o fibrilación ventricular. Las arritmias ventriculares malignas son causadas por dispersión de la repolarización transmural y/o retraso en la conducción del tracto de salida del ventrículo derecho. Predomina en el sexo masculino y el debut ocurre con más frecuencia en edades medias de la vida. El riesgo de nuevos eventos en los sintomáticos es del 30-40 % en los 3 años subsiguientes al diagnóstico. El tratamiento de elección es el implante de un desfibrilador automático. La quinidina se ha utilizado en pacientes con desfibriladores implantados y eventos frecuentes de arritmias ventriculares, así como en los que no desean implantarse esos dispositivos. La conducta a seguir en los asintomáticos es debatida. En la base de datos del servicio de arritmias del Instituto de Cardiología hay más de 80 pacientes con este síndrome, 45 con desfibriladores automáticos implantados.


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