Hou Cui-hong, Wang Jing, Hao Su-fang, Chu Jian-min, Pu Jie-lin, Zhang Shu
Center for Arrhythmia Diagnosis and Treatment, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2012 Jun;40(6):502-4.
To summarize the clinical characteristics and treatment experience of patients with non-myxomas primary cardiac tumors accompanied with refractory ventricular tachycardia (VT).
Clinical and imaging data as well as therapy efficacy and outcome were analyzed in 10 patients with non-myxomas primary cardiac tumors accompanied with refractory VT.
There were 5 male and 5 female patients in this cohort [mean age (37.6±18.2) years]. Palpitation was presented in all 10 patients, 7 patients experienced syncope, and 2 patients suffered from amaurosis. The diagnosis was made by combined use of transthoracic echocardiograms, MRI, and CT scan. The time from symptom to diagnosis was (33.2±36.7) months. Symptom-related VT was documented by ECG or Holter monitoring. MRI suggested lipoma in 7 patients, lymphoma in 1 patient and fibroma in another patient. Seven tumors were located in the left ventricle, 1 in right atria, 1 at peri-aortic root and 1 near right ventricular outflow tract. Nine out of 10 patients received anti-arrhythmic drug therapy. The ventricular tachyarrhythmia disappeared after surgical tumor resection in 4 patients. All other patients who were treated with antiarrhythmic drugs, radiofrequency ablation or subtotal excision showed only suboptimal efficacy during (39.4±25.1) months follow-up.
Surgical tumor removal is the best treatment strategy for the treatment of refractory ventricular tachycardia in patients with primary cardiac benign tumors.
总结非黏液瘤性原发性心脏肿瘤合并难治性室性心动过速（VT）患者的临床特征及治疗经验。
对10例非黏液瘤性原发性心脏肿瘤合并难治性VT患者的临床和影像学资料以及治疗效果和转归进行分析。
该队列中有5例男性和5例女性患者[平均年龄（37.6±18.2）岁]。10例患者均有心悸症状，7例患者发生晕厥，2例患者出现黑矇。通过经胸超声心动图、MRI和CT扫描联合检查做出诊断。从症状出现到确诊的时间为（33.2±36.7）个月。症状相关性VT通过心电图或动态心电图监测记录。MRI提示7例为脂肪瘤，1例为淋巴瘤，另1例为纤维瘤。7个肿瘤位于左心室，1个位于右心房，1个位于主动脉根部周围，1个靠近右心室流出道。10例患者中有9例接受了抗心律失常药物治疗。4例患者在手术切除肿瘤后室性心律失常消失。所有其他接受抗心律失常药物、射频消融或次全切除治疗的患者在（39.4±25.1）个月的随访期间疗效均欠佳。
手术切除肿瘤是治疗原发性心脏良性肿瘤合并难治性室性心动过速的最佳治疗策略。
