Panizo Jorge G, Barra Sergio, Mellor Greg, Heck Patrick, Agarwal Sharad
Royal Papworth Hospital NHS Foundation Trust, Cambridge University Health Partners Cambridge, UK.
Arrhythm Electrophysiol Rev. 2018 Jun;7(2):128-134. doi: 10.15420/aer.2018.23.2.
Premature ventricular complex-induced cardiomyopathy is a potentially reversible condition in which left ventricular dysfunction is induced by the occurrence of frequent premature ventricular complexes (PVCs). Various cellular and extracellular mechanisms and risk factors for developing cardiomyopathy in this context have been suggested but the exact pathophysiological mechanism remains unclear. The suppression of PVCs is usually indicated in symptomatic patients with frequent PVCs and also those with left ventricular dysfunction. Antiarrhythmic drugs are a useful non-invasive treatment to eliminate PVCs, but the side effect profile, including the risk of pro-arrhythmia, along with suboptimal clinical effectiveness, should be weighed against the usually more effective but not risk-free treatment with catheter ablation. The latter has progressively become first line therapy in many patients with PVC-induced cardiomyopathy and should be particularly considered in specific scenarios.
室性早搏诱发的心肌病是一种潜在可逆的病症,其中频繁室性早搏(PVC)的发生会诱发左心室功能障碍。在这种情况下,已经提出了各种导致心肌病的细胞和细胞外机制及危险因素,但确切的病理生理机制仍不清楚。对于有频繁PVC的有症状患者以及有左心室功能障碍的患者,通常建议抑制PVC。抗心律失常药物是消除PVC的一种有用的非侵入性治疗方法,但应权衡其副作用,包括致心律失常风险以及欠佳的临床疗效,与通常更有效但并非无风险的导管消融治疗。在许多PVC诱发的心肌病患者中,导管消融逐渐成为一线治疗方法,并且在特定情况下应特别予以考虑。