Kalla H, Yan G X, Marinchak R
Lankenau Hospital, Wynnewood, Pennsylvania, USA.
J Cardiovasc Electrophysiol. 2000 Jan;11(1):95-8. doi: 10.1111/j.1540-8167.2000.tb00743.x.
Recurrent ventricular fibrillation was observed in a 29-year-old Vietnamese man who did not exhibit structural heart disease. The patient's ECG showed prominent J (Osborn) waves and ST segment elevation in the inferior leads that were not associated with hypothermia, serum electrolyte disturbance, or myocardial ischemia. Rate-dependent change in the amplitude of J waves and ST segment elevation also were observed. An implantable cardioverter defibrillator (ICD) was implanted. Adjunctive treatment with amiodarone reduced J wave amplitude, preventing ventricular fibrillation and ICD shocks. Prominent J waves and ST segment elevation in the inferior leads may serve as an important diagnostic sign to detect high-risk individuals with a history of unexplained syncope. ICD implantation plus amiodarone is the treatment of choice.
在一名无结构性心脏病的29岁越南男性中观察到复发性室颤。患者心电图显示下壁导联有明显的J（奥斯本）波和ST段抬高，与体温过低、血清电解质紊乱或心肌缺血无关。还观察到J波振幅和ST段抬高的心率依赖性变化。植入了植入式心脏复律除颤器（ICD）。胺碘酮辅助治疗降低了J波振幅，预防了室颤和ICD电击。下壁导联明显的J波和ST段抬高可能是检测有不明原因晕厥病史的高危个体的重要诊断标志。ICD植入加胺碘酮是首选治疗方法。
