Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA.
Circ Arrhythm Electrophysiol. 2013 Aug;6(4):712-8. doi: 10.1161/CIRCEP.113.000444. Epub 2013 Jun 7.
Ventricular arrhythmia-related sudden cardiac arrest in infants with structurally normal hearts is rare. There have been no previously published reports of infants <3 months of age with ventricular fibrillation in which a primary diagnosis could not be defined.
Retrospective chart review of 3 unrelated infants <2 months of age from 3 different tertiary care centers within the United States and Australia was conducted. All 3 infants survived sudden cardiac arrest secondary to multiple episodes of polymorphic ventricular tachycardia and ventricular fibrillation. Each infant demonstrated unique and transient ECG findings consisting of ST changes and QRS widening before arrhythmia onset, which have not been previously reported. Amiodarone, sedation, sodium channel-blocking agents, and ventricular pacing were effective in suppressing acute events. Despite thorough investigation, including genetic testing, the cause of ventricular arrhythmias in each of these infants remains unclear.
This is the first report of idiopathic ventricular fibrillation in young infants preceded by stereotypical transient ECG changes. These findings may represent a new, potentially treatable cause of sudden infant death. Recognition of these prodromal changes may be important in future management and survival of these infants.
结构正常的婴儿发生与室性心律失常相关的心脏性骤停较为罕见。此前尚无<3 个月龄婴儿发生无法明确原发性诊断的室颤的报道。
对来自美国和澳大利亚的 3 家三级医疗中心的 3 例年龄<2 个月的无关联婴儿进行了回顾性图表审查。所有 3 例婴儿均存活，原因是反复发作多形性室性心动过速和室颤导致心搏骤停。每个婴儿在心律失常发作前都表现出独特且短暂的心电图表现，包括 ST 段改变和 QRS 波增宽，这些之前并未有过报道。胺碘酮、镇静、钠通道阻滞剂和心室起搏在抑制急性事件方面均有效。尽管进行了全面的调查，包括基因检测，但这些婴儿的室性心律失常的病因仍不明确。
这是首例报告年轻婴儿发生特发性室颤，之前有典型的短暂性心电图改变。这些发现可能代表一种新的、潜在可治疗的婴儿猝死原因。认识到这些前驱性改变可能对这些婴儿的未来管理和存活很重要。
