Maia I G, Sá R, Bassan R, Alves P, Ribeiros J C, Loyola L H, Cruz Filho F E, Valverde A, Belém L
Hospitais de Cardiologia de Laranjeiras/Lagoa/Pró-Cardíaco-Pró-Ritmo, Rio de Janeiro.
Arq Bras Cardiol. 1991 Aug;57(2):97-102.
To evaluate the clinical findings and complementary investigation to support the diagnosis of arrhythmogenic right ventricular dysplasia.
Six males with a mean age of 40 years old with episodes of sustained ventricular tachycardia with left bundle branch block pattern. All patients were submitted to a clinical investigation, EKG X rays and echocardiograms. In five patients an electrophysiologic study was performed. All patients were treated with anti-arrhythmic drugs.
Palpitation was the most common complaint. T-wave inversion in leads V1-V3 was present in 4 patients. An epsilon wave was noted in 2 patients. The chest X ray was abnormal in only 1 patient. All patients had an abnormal echocardiogram, with consisted in the dilatation of the outflow tract of the RV and hypocontractility. In 2 patients aneurysm of the basal RV free wall below tricuspid valve were detected. Ventricular post-excitation waves were present in 4 patients. After a mean follow-up of 37 months, 5 patients were asymptomatic with anti-arrhythmic drugs and one in therapeutic adjustment.
In patients with ventricular tachycardia with left bundle branch block pattern, the diagnosis of arrhythmogenic right ventricular dysplasia was substantiated by echocardiographic data and electrocardiographic findings such a T-wave inversion during sinus rhythm and ventricular post-excitation waves. The results obtained with anti-arrhythmic drugs in our study group, suggest that drug therapy should be the first and best approach to treat patients with this type of pathology.
评估支持致心律失常性右室心肌病诊断的临床发现及辅助检查。
6名男性患者，平均年龄40岁，有持续性室性心动过速发作且呈左束支传导阻滞图形。所有患者均接受了临床检查、心电图、X线检查及超声心动图检查。5名患者进行了电生理研究。所有患者均接受了抗心律失常药物治疗。
心悸是最常见的主诉。4例患者V1-V3导联出现T波倒置。2例患者记录到epsilon波。仅1例患者胸部X线检查异常。所有患者超声心动图均异常，表现为右室流出道扩张及收缩功能减退。2例患者检测到三尖瓣下方右室游离壁基底段动脉瘤。4例患者出现心室后激动波。平均随访37个月后，5例患者使用抗心律失常药物无症状，1例患者正在调整治疗方案。
对于呈左束支传导阻滞图形的室性心动过速患者，致心律失常性右室心肌病的诊断可通过超声心动图数据及心电图表现（如窦性心律时T波倒置和心室后激动波）得到证实。我们研究组使用抗心律失常药物获得的结果表明，药物治疗应是治疗此类疾病患者的首选且最佳方法。
