Boston University School of Medicine, Boston, Massachusetts, USA.
815 Albany Street #512B, Boston, MA 02119, USA, Email:
J R Coll Physicians Edinb. 2021 Sep;51(3):262-265. doi: 10.4997/JRCPE.2021.311.
Premature ventricular contractions (PVCs) are heart beats initiated in the ventricles instead of in the sinoatrial node. A high burden of PVCs can lead to a cardiomyopathy, characterised by reduced left ventricular (LV) systolic dysfunction. We present a case of PVC-related cardiomyopathy where the 65-year-old male was initially seen by his primary care provider for recent onset chest pain and dizziness. His transthoracic echocardiogram showed mild concentric LV hypertrophy and mildly reduced systolic function (LV ejection fraction 43%). There was also mild right ventricular (RV) systolic dysfunction. He was started on a beta-blocker and an angiotensin-converting enzyme inhibitor. A 24-hour Holter monitor showed a very high burden of PVCs (32% of all beats). He continued to have frequent PVCs and his echocardiogram did not improve. He was eventually referred for a PVC ablation. Following the ablation, a repeat Holter monitor showed a marked reduction in PVC burden (<1% of beats) and his echocardiogram had normalised.
室性期前收缩（PVCs）是起源于心室而不是窦房结的心跳。PVCs 的负担过高可导致心肌病，其特征为左心室（LV）收缩功能降低。我们报告了一例 PVC 相关性心肌病，该 65 岁男性最初因近期发作胸痛和头晕就诊于其初级保健提供者。他的经胸超声心动图显示轻度向心性 LV 肥厚和轻度收缩功能降低（LV 射血分数 43%）。也有轻度右心室（RV）收缩功能障碍。他开始服用β受体阻滞剂和血管紧张素转换酶抑制剂。24 小时动态心电图显示 PVCs 的负担非常高（占所有心跳的 32%）。他仍经常出现 PVCs，且超声心动图未见改善。他最终被转介进行 PVC 消融。消融后，重复 Holter 监测显示 PVC 负担明显减少（<1%的心跳），超声心动图恢复正常。
