Yamada Takumi
Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA.
J Cardiol. 2016 Dec;68(6):463-471. doi: 10.1016/j.jjcc.2016.06.001. Epub 2016 Jul 9.
Idiopathic ventricular arrhythmias (VAs) are ventricular tachycardias (VTs) or premature ventricular contractions (PVCs) whose mechanisms are not related to myocardial scar. Idiopathic VAs occur most commonly without structural heart disease, but can occur with structural heart disease. Imaging tests, such as echocardiography, nuclear test, and cardiac magnetic resonance imaging, are helpful for excluding any association of an idiopathic VA occurrence with myocardial scar. Since catheter ablation emerged, the sites of idiopathic VA origins, commonly endocardial but sometimes epicardial, have been increasingly recognized. Idiopathic VAs usually originate from specific anatomical structures, and exhibit characteristic electrocardiograms based on their anatomical background. Idiopathic VAs are basically benign, but they require medical treatment or catheter ablation when idiopathic VAs are symptomatic, incessant, or produce left ventricular dysfunction. This review describes the up-to-date information on the prevalence of idiopathic VA origins relevant to the anatomy, and diagnosis, and treatment of idiopathic VAs.
特发性室性心律失常（VA）是指机制与心肌瘢痕无关的室性心动过速（VT）或室性早搏（PVC）。特发性VA最常发生于无结构性心脏病的情况下，但也可与结构性心脏病同时出现。超声心动图、核素检查和心脏磁共振成像等影像学检查有助于排除特发性VA发生与心肌瘢痕的任何关联。自导管消融出现以来，特发性VA起源部位（通常为心内膜，但有时为心外膜）已得到越来越多的认识。特发性VA通常起源于特定的解剖结构，并根据其解剖背景表现出特征性心电图。特发性VA基本上是良性的，但当特发性VA有症状、持续性发作或导致左心室功能障碍时，则需要进行药物治疗或导管消融。本综述描述了与特发性VA的解剖、诊断和治疗相关的特发性VA起源部位患病率的最新信息。
