Satoh M, Aizawa Y, Murata M, Suzuki K, Aizawa M, Funazaki T, Shibata A, Miyamura H, Eguchi S, Matsukawa T
First Department of Internal Medicine, Niigata University School of Medicine, Japan.
Jpn Heart J. 1988 Jan;29(1):69-77. doi: 10.1536/ihj.29.69.
We performed an electrophysiologic study (EPS) in 8 patients who had received corrective surgery for tetralogy of Fallot. The mean age was 30 years. An average of 15 years had elapsed after corrective surgery. Two patients had episodes of syncope. ECG showed normal sinus rhythm in 7 patients and atrial fibrillation in 1, and all had complete right bundle branch block. All patients had ventricular premature beats of grade 3 or higher of Lown's classification. Overdrive suppression test was performed in 6 patients. Corrected sinus node recovery time (CSNRT) ranged from 230 msec to 510 msec. Wenckebach block of atrioventricular nodal conduction occurred at rates of 130 to 170 bpm during atrial pacing. The H-V interval was prolonged to 60 msec in 1 patient, but was below 55 msec in the others. Programmed stimulation induced ventricular tachycardia (VT) in 3 patients, nonsustained VT in 2 and sustained VT in 1. In 2 of 3 patients, delayed potential or fragmentations were recorded in the outflow tract of the right ventricle. During the follow-up period of 20 months, 2 patients died suddenly. Their CSNRTs and H-V intervals were normal. Ventricular tachyarrhythmia seems to be important as a cause of late sudden death after repair of tetralogy of Fallot.
我们对8例接受法洛四联症矫正手术的患者进行了电生理研究（EPS）。平均年龄为30岁。矫正手术后平均过去了15年。2例患者有晕厥发作。心电图显示7例患者为正常窦性心律，1例为心房颤动，所有患者均有完全性右束支传导阻滞。所有患者均有Lown分级3级或更高的室性早搏。对6例患者进行了超速抑制试验。校正窦房结恢复时间（CSNRT）为230毫秒至510毫秒。心房起搏时，房室结传导的文氏阻滞发生在130至170次/分的频率。1例患者的H-V间期延长至60毫秒，其他患者低于55毫秒。程控刺激诱发出3例室性心动过速（VT），2例非持续性VT，1例持续性VT。在3例患者中的2例，右心室流出道记录到延迟电位或碎裂电位。在20个月的随访期内，2例患者突然死亡。他们的CSNRT和H-V间期正常。室性快速心律失常似乎是法洛四联症修复术后晚期猝死的重要原因。
