Koplan Bruce A, Stevenson William G
Cardiac Arrhythmia Section, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02446, USA.
Mayo Clin Proc. 2009 Mar;84(3):289-97. doi: 10.4065/84.3.289.
Ventricular tachycardia (VT), which most commonly occurs in patients with structural heart disease, can be associated with an increased risk of sudden death. The most common cause of ventricular fibrillation is acute coronary ischemia, whereas a myocardial scar from prior infarct is the most common cause of sustained monomorphic VT in patients with structural heart disease. More benign forms of idiopathic VT can also occur in the absence of structural heart disease. Treatment of VT involves both emergent management and prevention of recurrence with medical and device therapy. Appropriately selected patients who have experienced VT or those who are at risk of VT may be candidates for an implantable cardioverter-defibrillator. The left ventricular ejection fraction is most frequently used to stratify patients with either ischemic or nonischemic cardiomyopathy who are at risk of sudden death and may be candidates for a prophylactic defibrillator. Catheter ablation may also be an option for appropriately selected patients with many forms of VT. This article discusses the etiologies and management of VT and its association with sudden death.
室性心动过速（VT）最常见于患有结构性心脏病的患者，可伴有猝死风险增加。心室颤动最常见的原因是急性冠状动脉缺血，而既往梗死形成的心肌瘢痕是结构性心脏病患者持续性单形性室性心动过速最常见的原因。在无结构性心脏病的情况下也可发生更良性的特发性室性心动过速。室性心动过速的治疗包括紧急处理以及通过药物和器械治疗预防复发。经历过室性心动过速的适当选择的患者或有室性心动过速风险的患者可能是植入式心脏复律除颤器的候选人。左心室射血分数最常用于对有猝死风险且可能是预防性除颤器候选人的缺血性或非缺血性心肌病患者进行分层。对于许多形式的室性心动过速，导管消融也可能是适当选择的患者的一种选择。本文讨论了室性心动过速的病因、管理及其与猝死的关联。
