Abstract：
Risk stratification of patients with Brugada syndrome (BrS) remains challenging. Signal-averaged electrocardiogram (SAECG) is a noninvasive tool that can be used to identify the electrophysiologic substrate potentially underlying fatal ventricular arrhythmias. The aim of this meta-analysis is to summarize the existing evidence about the role of late potentials (LP) as a predictor for arrhythmic events in patients with BrS. A systematic search in the MedLine database through to June 2022 without any limitations was performed. Ten studies were included in the quantitative synthesis (1431 patients with BrS, mean age 47.4 years, males 86%). Of these, 1220 patients underwent SAECG evaluation (53.2% had positive LP, and 20.6% had a fatal arrhythmic event). There was a nonsignificant association between positive LPs and fatal arrhythmic events [RR: 2.06 (0.98-4.36), P = 0.06, I 2 = 82%]. By including only studies with patients without a history of fatal arrhythmia, the association between LP with arrhythmic events remained nonsignificant [RR: 1.29 (0.67-2.48), P = 0.44, I 2 = 54%]. In conclusion, there is a possible association between LP and fatal arrhythmic events in patients with BrS, but the literature remains inconclusive. Large cohort studies using a multiparametric approach for risk stratification purposes are needed to improve the risk stratification of BrS and to optimize the selection of BrS patients that should be referred for implantable cardioverter-defibrillator.
摘要：
Brugada综合征（BrS）患者的风险分层仍然具有挑战性。信号平均心电图（SAECG）是一种非侵入性工具，可用于识别潜在的致命室性心律失常的电生理底物。这项荟萃分析的目的是总结有关晚期电位（LP）作为BrS患者心律失常事件预测因子的现有证据。在MedLine数据库中进行了直到2022年6月的系统搜索，没有任何限制。定量综合纳入了10项研究(1431例BrS患者，平均年龄47.4岁，男性86%)。其中,1220例患者接受了SAECG评估（53.2%LP阳性，20.6%有致命的心律失常事件)。阳性LP与致死性心律失常事件之间无显著关联[RR:2.06(0.98-4.36),P=0.06,I2=82%]。通过仅包括没有致命心律失常史的患者的研究，LP与心律失常事件之间的关联仍然不显着[RR：1.29（0.67-2.48），P=0.44，I2=54%]。总之,在BrS患者中，LP与致死性心律失常事件之间可能存在关联，但是文献仍然没有定论。需要使用多参数方法进行风险分层的大型队列研究，以改善BrS的风险分层，并优化应推荐植入式心律转复除颤器的BrS患者的选择。
