伴极短联律间距的多形性室性心动过速（附七例报告及随访）  

Polymorphous VT with extremely short coupling interval ──A report of sevem cases with follow-up study

作　　者：戚文航[1] 龚兰生[1] 石镭[1] 钱剑安[1] 

机构地区：[1]上海第二医科大学附属瑞金医院心脏科

出　　处：《中华心血管病杂志》1994年第3期192-194,共3页Chinese Journal of Cardiology

摘　　要：报道一组特殊类型的多形性室性心动过速（室速），以正常ＱＴ间期伴极短联律间距为心电图特征；临床上有反复晕厥发作而无器质性心脏疾病证据；治疗上通常对Ⅰ、Ⅱ、Ⅲ类抗心律失常药无效而对维拉帕米治疗十分敏感。４例心内电生理检查未能诱发室速。１例心肌活检示非特异性心肌炎性病变。该类室速具有高度致命性，必须及时识别给予准确治疗，并需坚持服药。本组随访最长已７年半。本类室速的发病机理尚不明确，可能与触发活动或钙离子流折返有关。Abstract Seven cases with polymorphous VT in particular pattern are reported. The electrocardiographic characteristics showed the presence of extremely short coupling interval of isolated PVCs as well as the PVCs initiating tachycardias in the setting of normal QT intervals. The techycardias were susceptible to verapamil and refractory to other antiarrhythmic agents. Five cases were followed up with the longest period of 7.5years in one case. Three cases had sudden death after stop of taking verapamil. Four cases underwent EPS with result of negative induction. one case had a myocardial biopsy showing a profile of nonspecific myocarditis. The pathogenesis of this malignant tachyarrhythmia still remained controversial. Either triggered activity or reentry due to slow. inward current is considered relevant to the mechanism of this kind of arrhythmia.

关 键 词：心动过速 维拉帕米 心电图 

分 类 号：R541.71[医药卫生—心血管疾病]