Mlcochova Hanka, Saliba Walid I, Burkhardt David J, Rodriguez Rene E, Cummings Jennifer E, Lakkireddy Dhanunjaya, Patel Dimpi, Natale Andrea
Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
J Cardiovasc Electrophysiol. 2006 Apr;17(4):426-30. doi: 10.1111/j.1540-8167.2005.00321.x.
Recent studies have demonstrated that premature ventricular contractions (PVCs) originating from the Purkinje system are responsible for initiation of ventricular fibrillation (VF) in patients with and without structural heart disease. Ablation of the PVCs has been shown to be feasible. We report 2 patients with repetitive VF associated with cardiac amyloidosis. Each episode of ventricular arrhythmia was preceded by monomorphic PVC. The electrical storms were drug resistant. Electrophysiological testing was performed and the sites of earliest activation were localized within the left ventricle in the absence of significant scar tissue. After ablation, PVCs subsided and there were no further VF recurrences.
近期研究表明，起源于浦肯野系统的室性早搏（PVCs）是导致有或无结构性心脏病患者发生心室颤动（VF）的原因。已证明消融PVCs是可行的。我们报告2例与心脏淀粉样变性相关的反复VF患者。每次室性心律失常发作之前均有单形性PVC。电风暴对药物耐药。进行了电生理检查，最早激动部位定位于左心室内且无明显瘢痕组织。消融后，PVCs消失，未再发生VF。
