Lemery R, Brugada P, Della Bella P, Dugernier T, Wellens H J
Department of Cardiology, University of Limburg, University Hospital, Maastricht, The Netherlands.
J Am Coll Cardiol. 1989 Mar 15;13(4):911-6. doi: 10.1016/0735-1097(89)90235-0.
Findings are described in six patients with no clinical evidence of heart disease who had documented ventricular fibrillation (five patients) or ventricular flutter (one patient). The mean age of the six patients, all men, was 34 years (range 26 to 43). Cardiovascular collapse occurred in all and was followed by successful cardioversion. No patient had electrolyte or QT abnormalities. One patient had slight right ventricular enlargement on M-mode echocardiography, and another had a left ventricular pressure gradient at rest of 30 mm Hg with a normal two-dimensional echocardiogram. Holter electrocardiographic monitoring revealed incessant ventricular tachycardia in one patient and nonsustained ventricular tachycardia in three others. Exercise testing revealed nonsustained ventricular tachycardia in one patient. Ventricular fibrillation was induced at the time of programmed electrical stimulation in four of the six patients. Documented recurrence of ventricular fibrillation or ventricular flutter occurred in three patients, but in only one patient receiving antiarrhythmic drugs. Four patients were treated with amiodarone and one received an automatic implantable cardioverter-defibrillator. All patients are alive after a mean follow-up period of 78 months after the first documentation of their arrhythmia and 37 months after programmed electrical stimulation. Ventricular fibrillation can occur in the apparently structurally normal human heart. Antiarrhythmic treatment can provide effective control of this malignant arrhythmia.
对6例无心脏病临床证据的患者进行了观察，这些患者记录有心室颤动（5例）或心室扑动（1例）。6例患者均为男性，平均年龄34岁（范围26至43岁）。所有患者均发生心血管虚脱，随后成功进行了心脏复律。所有患者均无电解质或QT异常。1例患者M型超声心动图显示右心室轻度扩大，另1例患者静息时左心室压力阶差为30 mmHg，二维超声心动图正常。动态心电图监测显示，1例患者有持续性室性心动过速，另3例有非持续性室性心动过速。运动试验显示1例患者有非持续性室性心动过速。6例患者中有4例在程序电刺激时诱发了心室颤动。3例患者记录到心室颤动或心室扑动复发，但只有1例接受抗心律失常药物治疗。4例患者接受了胺碘酮治疗，1例接受了植入式自动心脏复律除颤器治疗。所有患者在首次记录心律失常后平均随访78个月，在程序电刺激后平均随访37个月，均存活。心室颤动可发生于结构看似正常的人体心脏。抗心律失常治疗可有效控制这种恶性心律失常。
