Raffles Heart Centre, Raffles Hospital, 585 North Bridge Road, #12-00, Singapore 188770.
Singapore Med J. 2011 Oct;52(10):707-13; quiz 714.
How important are PVCs and what should we do about them? PVCs are not a disease in themselves, but a marker of possible underlying conditions that may increase the risk of cardiac death. They serve as a flag to alert us to exclude structural heart disease, the presence of which is the strongest predictor of adverse events. However, it is important to know that PVCs are common in people with no structural heart disease. In this situation, the prognosis is generally excellent. Suppression of PVCs with antiarrhythmic medication is not indicated routinely, unless the patient is symptomatic or at risk of tachycardia-induced cardiomyopathy owing to the very high frequency of PVCs. Where pharmacological therapy has failed, there is now the option of radiofrequency ablation for elimination of frequent symptomatic PVCs. The ECG is a simple yet useful tool to improve risk assessment, especially in those with known cardiovascular disease.
PVC 有多重要？我们应该如何处理？PVC 本身并不是一种疾病，而是可能存在潜在疾病的标志物，这些潜在疾病可能增加心源性死亡的风险。它们是一种警示，提醒我们排除结构性心脏病，因为结构性心脏病是预测不良事件的最强因素。然而，重要的是要知道，在没有结构性心脏病的人群中 PVC 也很常见。在这种情况下，预后通常很好。除非患者有症状或因 PVC 非常频繁而有发生心动过速性心肌病的风险，否则通常不建议常规使用抗心律失常药物来抑制 PVC。如果药物治疗失败，现在可以选择射频消融术来消除频繁有症状的 PVC。心电图是一种简单而有用的工具，可以提高风险评估，特别是在已知患有心血管疾病的人群中。
