Cardiovascular Research Center, Department of Cardiology, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.
Nat Rev Cardiol. 2011 Jun;8(6):311-21. doi: 10.1038/nrcardio.2011.15. Epub 2011 Feb 22.
The term 'ventricular arrhythmias' incorporates a wide spectrum of abnormal cardiac rhythms, from single premature ventricular complexes to sustained monomorphic ventricular tachycardia (VT), polymorphic VT, and ventricular fibrillation. Sustained ventricular arrhythmias are the most common cause of sudden cardiac death. These arrhythmias occur predominantly in patients with structural heart disease, but are also seen in patients with no demonstrable cardiac disease. The diagnosis of VT can be made reliably using electrocardiographic criteria, and a number of algorithms have been proposed. Among patients with VT and a structurally normal heart, the prognosis is usually benign and treatment is predominantly focused on the elimination of symptoms. Patients who have VT in the presence of structural heart disease are often managed with implantable cardioverter-defibrillators. These devices are effective for both primary and secondary prevention of VT and sudden cardiac death. Pharmacological therapy for VT has limited efficacy and is associated with a high incidence of adverse effects. Radiofrequency catheter ablation is useful for controlling recurrent episodes of monomorphic VT; however, research is needed to define the role of catheter ablation in the treatment of other ventricular arrhythmias.
“室性心律失常”包括广泛的异常心脏节律，从单一的室性期前收缩到持续性单形性室性心动过速（VT）、多形性 VT 和心室颤动。持续性室性心律失常是心脏性猝死的最常见原因。这些心律失常主要发生在结构性心脏病患者中，但也可见于无明显心脏病的患者中。VT 的诊断可以通过心电图标准可靠地做出，并且已经提出了许多算法。在 VT 和结构正常心脏的患者中，预后通常是良性的，治疗主要集中在消除症状上。在结构性心脏病患者中出现 VT 的患者通常采用植入式心脏复律除颤器进行治疗。这些设备对 VT 和心脏性猝死的一级和二级预防均有效。VT 的药物治疗疗效有限，且不良反应发生率高。射频导管消融术对控制单形性 VT 的反复发作有用；然而，需要研究来确定导管消融术在治疗其他室性心律失常中的作用。
