Guillerm F, Juillard A, Angelard T, Abiven M P, Gay J, Barrillon A, Gerbaux A
Arch Mal Coeur Vaiss. 1984 Jul;77(7):840-5.
The authors report a case of sustained ventricular tachycardia which occurred seven years after complete surgical correction of Fallot's tetralogy in a 13 year old girl. This arrhythmia was well tolerated haemodynamically, showed right-sided delay and was associated with mitral valve prolapse. After reviewing the literature, several physiopathological mechanisms are discussed: --the role of residual intraventricular conduction defects in sustaining the tachycardia; --the role of the ventriculotomy scar or of other associated lesions (mitral valve prolapse in this case) in the genesis of ventricular extrasystoles; --the postoperative haemodynamic status in the tolerance of the arrhythmias. This is a rare complication with an incidence of less than 2% of survivors followed-up over long periods. There is a risk of sudden death in 38% of these patients with ventricular arrhythmias which justifies Holter monitoring and ECG stress testing for their detection.
作者报告了一例持续性室性心动过速病例，该病例发生在一名13岁女孩接受法洛四联症完全手术矫正7年后。这种心律失常在血流动力学上耐受性良好，表现为右侧延迟，并与二尖瓣脱垂有关。在回顾文献后，讨论了几种生理病理机制：——残余室内传导缺陷在维持心动过速中的作用；——心室切开术瘢痕或其他相关病变（本例中的二尖瓣脱垂）在室性期前收缩发生中的作用；——心律失常耐受性方面的术后血流动力学状态。这是一种罕见的并发症，在长期随访的幸存者中发生率不到2%。这些室性心律失常患者中有38%存在猝死风险，这使得进行动态心电图监测和心电图负荷试验以检测心律失常成为必要。
