Sosa E, Marcial M B, Scanavacca M, Bellotti G, Pileggi F
Sao Paulo University Medical School Heart Institute (INCOR), Sao Paulo, Brazil.
Pacing Clin Electrophysiol. 1991 May;14(5 Pt 1):764-7. doi: 10.1111/j.1540-8159.1991.tb04103.x.
A patient with refractory and incessant ectopic atrial tachycardia (IEAT) is reported in whom it was possible to document, during ECG (Holter) the occurrence of aborted sudden death by spontaneous ventricular fibrillation (VF). Following the second of two attempts at surgical ablation of the origin of the IEAT, the patient has been asymptomatic without antiarrhythmic drugs and in sustained sinus rhythm for 24 months. Although we cannot exclude the residual action of amiodarone and flecainide (proarrhythmia) or the residual peripartum cardiomyopathy it is probable that the observed VF was a true complication of a cardiomyopathy induced by a chronically increased heart rate (HR). Although unclear, this VF might be considered as a form of adrenergic-dependent long QT syndrome due to early afterdepolarization in the presence of predisposing myocardial conditions.
本文报道了一名难治性持续性异位房性心动过速（IEAT）患者，在心电图（动态心电图）检查期间记录到其发生了因自发性心室颤动（VF）导致的心脏骤停。在两次尝试手术消融IEAT起源部位中的第二次之后，该患者在未使用抗心律失常药物的情况下一直无症状，且维持窦性心律达24个月。尽管我们不能排除胺碘酮和氟卡尼（致心律失常作用）的残留作用或残留的围产期心肌病，但观察到的VF很可能是慢性心率（HR）增加所致心肌病的一种真正并发症。尽管尚不清楚，但这种VF可能被视为一种在存在易患心肌状况时因早期后除极导致的肾上腺素能依赖性长QT综合征。
