Cosnay P, Fauchier J P, Philippe L, Casset D, Itti R, Moquet B, Mannara R, Huguet R G, Mustapha H
Service de cardiologie B, Hôpital Trousseau, Tours.
Arch Mal Coeur Vaiss. 1988 Apr;81(4):463-74.
Twenty-seven patients (15 men, 12 women; mean age 48.9 years) suffering from ventricular tachycardia (VT) (n = 30) were studied by radionuclide angiocardiography with Fourier phase analysis, both in sinus rhythm and during tachycardia. VT was spontaneous, electrically inducible, sustained, haemodynamically stable and monomorphous, with a mean rate of 174 beats/min (range: 115-260 beats). Heart diseases responsible for VT were: non-obstructive cardiomyopathy (n = 7), hypertrophic cardiomyopathy (n = 1), ischaemic heart disease (n = 5), probable right ventricular arrhythmogenic dysplasia (n = 4), congenital left ventricular aneurysm (n = 2), sequela of myocarditis (n = 2) and aortic valve regurgitation (n = 1); no heart disease was detectable in 5 patients. On surface electrocardiogram there was good concordance between the initial radionuclide site of VT activation and the configuration and electrical axis of QRS. At Fourier phase analysis all 17 VT of the right lag type originated in the left ventricle, arising from the apical septum (n = 7) or lateral segment (n = 2) in case of left axis, from the basal segment (n = 6) or the lateral segment (n = 1) in case of vertical or right axis, and from the middle left septum (n = 1) in case of normal axis. Nine VT of the left lag type originated in the right ventricle, arising from the basal septum or the latero-basal region in case of vertical or right axis (n = 6), from the apical septum or the inferior-apical region in case of left axis (n = 2) and from the middle septum in case of normal axis (n = 1). Four of our patients (3 with coronary disease and 1 with congenital left ventricular aneurysm) had VT of the left lag type and an initial radionuclide site of activation in the middle part of the left septum in case of left axis (n = 2) and in the basal part of that septum in case of right axis (n = 2). Seven patients were operated upon for recurrent VT: 4 had intra-operative mapping which in every case confirmed the results of radionuclide angiocardiography, a method which in the other 3 patients was the only surgeon's guide. Correlations between the site of origin of VT at radionuclide mapping and kinetic abnormalities visualized at radiological angiography and gamma-ray angiocardiography were common in our study. In one of our patients the same lesion gave birth to 2 VT of different morphologies.(ABSTRACT TRUNCATED AT 400 WORDS)
对27例（15例男性，12例女性；平均年龄48.9岁）患有室性心动过速（VT）（共30次发作）的患者，在窦性心律和心动过速期间进行了放射性核素心血管造影及傅里叶相位分析研究。VT为自发性、电诱导性、持续性、血流动力学稳定且形态单一，平均心率为174次/分钟（范围：115 - 260次）。导致VT的心脏病包括：非梗阻性心肌病（7例）、肥厚型心肌病（1例）、缺血性心脏病（5例）、可能的右心室致心律失常性发育异常（4例）、先天性左心室动脉瘤（2例）、心肌炎后遗症（2例）和主动脉瓣反流（1例）；5例患者未检测到心脏病。体表心电图显示，VT起始的放射性核素部位与QRS波的形态及电轴之间有良好的一致性。在傅里叶相位分析中，所有17例右滞后型VT均起源于左心室，左轴时起源于心尖间隔（7例）或外侧段（2例），垂直或右轴时起源于基底段（6例）或外侧段（1例），正常轴时起源于左中间间隔（1例）。9例左滞后型VT起源于右心室，垂直或右轴时起源于基底间隔或后基底区域（6例），左轴时起源于心尖间隔或下尖区域（2例），正常轴时起源于中间间隔（1例）。我们的4例患者（3例患有冠心病，1例患有先天性左心室动脉瘤）有左滞后型VT，左轴时初始放射性核素激活部位在左间隔中部（2例），右轴时在该间隔基部（2例）。7例患者因复发性VT接受了手术：4例进行了术中标测，结果均证实了放射性核素心血管造影的结果，该方法在另外3例患者中是唯一的手术指导。在我们的研究中，放射性核素标测时VT的起源部位与放射学血管造影和γ射线心血管造影中显示的动力学异常之间存在相关性。我们的1例患者同一病变引发了2种不同形态的VT。（摘要截断于400字）
