60例晕厥患者的电生理检查及治疗分析  

Electrophysiologic study in 60 patients with unexplained syncope

作　　者：陶惠伟[1] 林佳雄[1] 聂振宁[1] 刘少稳[2] 葛均波[1] 

机构地区：[1]复旦大学附属中山医院心内科,上海200032 [2]上海交通大学附属上海第一人民医院心内科,上海200080

出　　处：《中国心脏起搏与心电生理杂志》2009年第2期110-112,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨心内电生理检查对晕厥诊断及治疗的作用。方法回顾分析晕厥原因不明患者的电生理检查结果。分析有无器质性心脏病及心电图异常,晕厥病程及发作频率对电生理检查阳性率的影响。电生理检查后的治疗及随访。结果入选晕厥患者60例,电生理检查阳性患者14例。25例有器质性心脏病或心电图异常的患者中有9例阳性(36%);35例无器质性心脏病或心电图异常的患者中有5例阳性(14%)。3例无器质性心脏病或心电图异常的患者诱发出心室颤动后植入埋藏式心脏转复除颤器,平均随访2年均无放电。结论有器质性心脏病或心电图异常的晕厥患者电生理检查的阳性率较高,没有器质性心脏病或心电图异常的晕厥患者诱发心室颤动的临床意义需谨慎对待。Objective To investigate the value of electrophysiologic study （EPS） in patients with unexplained syncope. Methods Sixty consecutive patients with unexplained syncope who underwent EPS were studied retrospectively. The relationship between a positive EPS and the clinical characteristics （ history of syncope, frequency of syncope, abnormal electrocardiogram （ECG） and structural heart disease） was analyzed. After EPS, the patients were treated and followed. Results A positive EPS was observed in 14 patients （23%, 14/60）. In 25 patients with abnormal ECG or structural heart disease, EPS was positive in 9 patients （ 36% ）. Whereas in 35 patients with normal ECG and no structural heart disease, a positive EPS was only observed in 5 patients （ 14% ）. Ventricular fibrillation （VF） was induced in 3 patients with normal ECG and no structural heart disease, implantable cardioverter-defibrillators （ICD） were implanted in all of them. After a 2-year follow-up, no patients had an ICD discharge. Conclusion The diagnostic value of EPS is relatively high in syncope patients with abnormal ECG or structural heart disease. The clinical significance of VF induction during EPS in syncope patients with normal ECG and no structural heart disease merits further investigation.

关 键 词：电生理学 晕厥 电生理检查 特发性心室颤动 埋藏式心脏转复除颤器 

分 类 号：R544.2[医药卫生—心血管疾病] R331.38[医药卫生—内科学]