在长QT综合征患者中，短阵快速起搏后的停顿会引发后除极和尖端扭转型室速。

Pauses after burst pacing provoke afterdepolarizations and torsades de pointes in a patient with long QT syndrome.

作者信息

Kirchhof Paulus, Zellerhoff Stephan, Mönnig Gerold, Schulze-Bahr Eric

机构信息

Department of Cardiology and Angiology, University Hospital Münster, Germany.

出版信息

Heart Rhythm. 2004 Dec;1(6):720-3. doi: 10.1016/j.hrthm.2004.08.016.

DOI:10.1016/j.hrthm.2004.08.016

PMID:15851245

Abstract

A patient with long QT syndrome and syncope underwent electrophysiological testing and recording of monophasic action potentials (MAP). Programmed ventricular stimulation using up to three premature stimuli did not provoke arrhythmias. Transient action potential prolongation and afterdepolarizations were observed during pauses directly after high-rate fix frequent right ventricular burst pacing at 120-160 bpm. During the pause after burst pacing at 180 bpm, afterdepolarizations at 16-19% amplitude of the MAP plateau persisted for several beats and preceded a short episode of torsades de pointes. High-rate burst pacing provoked afterdepolarizations and triggered torsades de pointes in this patient with long QT syndrome.

摘要

一名患有长QT综合征和晕厥的患者接受了电生理检查并记录了单相动作电位（MAP）。使用多达三个期前刺激进行程控心室刺激未诱发心律失常。在以120 - 160次/分钟的频率进行高速固定频率右心室短阵猝发起搏后的间歇期，观察到短暂的动作电位延长和后除极。在以180次/分钟的频率进行短阵猝发起搏后的间歇期，MAP平台期幅度为16% - 19%的后除极持续了几个搏动，并先于一段短暂的尖端扭转型室速发作。高速短阵猝发起搏在该长QT综合征患者中诱发了后除极并触发了尖端扭转型室速。