de Paola A A, Horowitz L N, Miyamoto M H, Pinheiro R, Ferreira D F, Terzian A B, Cirenza C, Guiguer N, Portugal O P
Division of Clinical Cardiac Electrophysiology, Hospital São Paulo, Escola Paulista de Medicina, Brazil.
Am J Cardiol. 1990 Feb 1;65(5):360-3. doi: 10.1016/0002-9149(90)90302-h.
Forty-three consecutive symptomatic patients with chronic Chagasic myocarditis and ventricular tachycardia (VT) underwent clinical evaluation, 24-hour Holter monitoring, left ventricular angiography and electrophysiologic testing including programmed ventricular stimulation at 3 drive cycle lengths at 2 sites in the right ventricle. The mean ejection fraction was 42 +/- 10%. Sixteen patients had clinical sustained VT and 27 nonsustained VT. VT was reproducibly initiated in 13 of 16 (81%) patients with sustained VT and in 14 of 27 (52%) patients with nonsustained VT. Electrocardiographic conduction disturbances were seen in 15 of 16 (94%) patients with sustained VT and in 17 of 27 (63%) patients with nonsustained VT (p less than 0.05). Five of 16 (31%) sustained VT and none of nonsustained VT patients had left ventricular aneurysms (p less than 0.05). These data indicate that VT is frequently inducible in patients with sustained VT and nonsustained VT and chronic Chagasic myocarditis. An association appears to be present between conduction disturbances on the electrocardiogram, left ventricular aneurysms and development of sustained ventricular arrhythmias.
43例连续的有症状的慢性恰加斯性心肌炎合并室性心动过速（VT）患者接受了临床评估、24小时动态心电图监测、左心室血管造影以及电生理检查，包括在右心室两个部位以3个驱动周期长度进行程控心室刺激。平均射血分数为42±10%。16例患者有临床持续性VT，27例有非持续性VT。16例持续性VT患者中有13例（81%）、27例非持续性VT患者中有14例（52%）可重复性诱发VT。16例持续性VT患者中有15例（94%）、27例非持续性VT患者中有17例（63%）出现心电图传导障碍（p<0.05）。16例持续性VT患者中有5例（31%）有左心室室壁瘤，非持续性VT患者中无一例有左心室室壁瘤（p<0.05）。这些数据表明，持续性VT和非持续性VT以及慢性恰加斯性心肌炎患者中VT常常可诱发。心电图传导障碍、左心室室壁瘤与持续性室性心律失常的发生之间似乎存在关联。
