Pedersen D H, Zipes D P, Foster P R, Troup P J
Circulation. 1979 Nov;60(5):988-97. doi: 10.1161/01.cir.60.5.988.
In this study, we describe the findings in 18 young patients (age range 4 days to 24 years, mean 16.6 years) who had ventricular tachycardia and/or ventricular fibrillation and were followed for 4--70 months (mean 22.4 months). Patients had a variety of problems associated with their arrhythmia, including mitral valve prolapse, cardiomyopathy, myocarditis, prolonged QT syndrome and hypokalemia. Six patients had no clinically recognizable cardiac abnormality. The ventricular tachycardia showed a left bundle branch block contour in 10 of 17 patients, right bundle branch block in four, was multiform in two and had an indeterminate contour in one. Sustained ventricular tachycardia was initiated and terminated reproducibly by atrial and ventricular stimulation in three of seven patients who did not have spontaneous episodes of ventricular tachycardia during the electrophysiologic study. In one other patient, short bursts of ventricular tachycardia were induced. Patients who had ventricular fibrillation, those who died, and those who are still symptomatic with poorly controlled ventricular arrhythmias had significant heart disease. In one patient, a ventricular tachyarrhythmia that had required more than 100 electrical cardioversions spontaneously disappeared after requiring 1 year of antiarrhythmic therapy.
在本研究中，我们描述了18例年轻患者（年龄范围4天至24岁，平均16.6岁）的研究结果，这些患者患有室性心动过速和/或室颤，并接受了4至70个月（平均22.4个月）的随访。患者存在与心律失常相关的各种问题，包括二尖瓣脱垂、心肌病、心肌炎、长QT综合征和低钾血症。6例患者无临床可识别的心脏异常。17例患者中，10例室性心动过速表现为左束支传导阻滞图形，4例为右束支传导阻滞图形，2例为多形性，1例图形不确定。在电生理研究期间无室性心动过速自发发作的7例患者中，3例通过心房和心室刺激可重复性地诱发和终止持续性室性心动过速。在另一例患者中，诱发了短阵室性心动过速。发生室颤的患者、死亡患者以及仍有症状且室性心律失常控制不佳的患者患有严重心脏病。1例患者在接受1年抗心律失常治疗后，曾需要100多次电复律的室性快速心律失常自发消失。
