Coumel P, Lucet V
Ann Cardiol Angeiol (Paris). 1986 Apr;35(4):205-14.
Advances in cardiac rhythm studies have led to more precise definitions of wave burst arrhythmias since they were first described by Dessertenne. This progress has also broadened the scope of these arrhythmias and the initially defined limits no longer apply. Prolonged Q-T syndromes, whether inherited or acquired, remain the standard, characterized by the ECG so typical of tachycardiac rhythms with long coupling of the initial extrasystole. In the congenital forms, neurogenic, sympathetic stimulation plays a triggering role, whereas sympathetic hypertonia of humoral origin protects acquired forms. Catecholaminergic ventricular tachycardia is clearly related to congenital Q-T syndrome and involves the same treatment, but tends to show idiosyncrasy to quinidine compounds, in common with acquired forms of Q-T syndrome. Short-coupling wave burst arrhythmias are congenital and in principle idiopathic. They have triggering factors in common with acquired prolonged Q-T syndromes, but their interactions with the autonomic nervous system are more complex; the vagus and sympathetic nerves are equally implicated and these interactions are curiously sensitive to calcium antagonists. These four related syndromes form an "ill-defined group" the limits of which will become clearer as more knowledge is acquired regarding the substrate and the interactions with the autonomic nervous system.
自从 Dessertenne 首次描述以来，心脏节律研究的进展已使对波群性心律失常有了更精确的定义。这一进展也拓宽了这些心律失常的范围，最初定义的界限已不再适用。无论是遗传性还是后天获得性的长 QT 综合征，仍然是标准情况，其心电图特征为心动过速节律且初始期前收缩的配对间期较长。在先天性形式中，神经源性、交感神经刺激起触发作用，而体液源性的交感神经张力亢进则保护后天获得性形式。儿茶酚胺能性室性心动过速与先天性 QT 综合征明显相关且治疗相同，但与后天获得性 QT 综合征一样，对奎尼丁类化合物往往表现出特异性。短配对波群性心律失常是先天性的，原则上是特发性的。它们与后天获得性长 QT 综合征有共同的触发因素，但它们与自主神经系统的相互作用更为复杂；迷走神经和交感神经均有涉及，且这些相互作用对钙拮抗剂异常敏感。这四种相关综合征构成一个“界限不明的组”，随着对其基质以及与自主神经系统相互作用的了解增多，其界限将变得更加清晰。
