Di Biase M, Favale S, Massari V, Amodio G, Chiddo A, Rizzon P
Division of Cardiology, University of Bari, Italy.
Eur Heart J. 1989 Sep;10 Suppl D:49-53. doi: 10.1093/eurheartj/10.suppl_d.49.
Programmed electrical stimulation (PES) was performed in 17 patients, mean age 31 +/- 8 years, with minor forms of right ventricular dysplasia diagnosed because of (1) premature ventricular beats (PVBs) of left bundle branch block (LBBB) morphology; (2) no clinical or non-invasive evidence of cardiac abnormalities; (3) angiographic evidence of right ventricular wall motion abnormalities and bioptic findings of fibro-adipose infiltration. Fifteen patients had frequent and complex PVBs while two had sustained ventricular tachycardia (VT). During PES, sustained VT was induced in 2/2 patients with spontaneous sustained VT; ventricular repetitive responses were induced in 2/15 cases (13%) with complex and frequent PVBs. In conclusion, in minor forms of right ventricular dysplasia, PES induces VT only in patients with clinical VT; on the contrary, in patients with PVBs it is only possible to induce repetitive ventricular responses in a small proportion of cases; it is therefore not possible to select patients at high risk of developing severe ventricular arrhythmias.
对17例平均年龄为31±8岁的患者进行了程控电刺激（PES），这些患者被诊断为轻度右心室发育不良，原因如下：（1）左束支传导阻滞（LBBB）形态的室性早搏（PVBs）；（2）无心脏异常的临床或非侵入性证据；（3）右心室壁运动异常的血管造影证据和纤维脂肪浸润的活检结果。15例患者有频繁且复杂的PVBs，2例有持续性室性心动过速（VT）。在PES期间，2例有自发性持续性VT的患者中2例诱发出持续性VT；15例有复杂且频繁PVBs的患者中有2例（13%）诱发出心室重复反应。总之，在轻度右心室发育不良中，PES仅在有临床VT的患者中诱发出VT；相反，在有PVBs的患者中，仅在一小部分病例中可能诱发出心室重复反应；因此，无法选择有发生严重室性心律失常高风险的患者。
