Dilaveris Polychronis, Vassilopoulos Charalambos, Tsagga Evaggelia, Vavuranakis Manolis, Stefanadis Christodoulos
1st Department of Cardiology, University of Athens Medical School, Athens, Greece.
Ann Noninvasive Electrocardiol. 2006 Jul;11(3):284-6. doi: 10.1111/j.1542-474X.2006.00117.x.
The occurrence of sudden cardiac death during Holter monitoring in patients with aortic stenosis has been reported previously. In the majority of the reported cases, the cause of death was a malignant ventricular tachyarrhythmia. The presence of a strong association between frequency and complexity of ventricular arrhythmias and sudden death in patients with aortic stenosis has been proposed. We report the case of a 77-year-old woman with aortic stenosis and atrial fibrillation who had an episode of torsades de pointes that degenerated into ventricular fibrillation during Holter monitoring. A short-long-short sequence, but not increased ventricular ectopics, precipitated torsades de pointes and sudden death in this case which is strongly indicative of triggered activity as the underlying mechanism of the lethal arrhythmia.
此前已有关于主动脉瓣狭窄患者在动态心电图监测期间发生心源性猝死的报道。在大多数报道的病例中，死亡原因是恶性室性快速心律失常。有人提出，主动脉瓣狭窄患者室性心律失常的频率和复杂性与猝死之间存在密切关联。我们报告了一例77岁患有主动脉瓣狭窄和心房颤动的女性病例，该患者在动态心电图监测期间发生了尖端扭转型室速，随后恶化为心室颤动。在该病例中，短-长-短序列而非室性早搏增加诱发了尖端扭转型室速和猝死，这强烈提示触发活动是致死性心律失常的潜在机制。
