Borggrefe M, Kuhn H, Königer H H, Stöter H, Breithardt G, Loogen F, Schulte H D, Bircks W
Eur Heart J. 1983 Nov;4 Suppl F:245-51. doi: 10.1093/eurheartj/4.suppl_f.245.
The surgical therapy of hypertrophic cardiomyopathy (HOCM) has been shown to improve symptoms and the haemodynamic status. The prognosis after transaortic subvalvular myectomy seems to be relatively better compared to those patients with HOCM who undergo medical therapy. Complex ventricular arrhythmias have been shown to influence prognosis. Therefore, a study was undertaken to analyse the influence of surgery on ventricular arrhythmias in patients with HOCM. Thirty-one patients (23 male, eight female), mean age 44 +/- 13.6 years (range 13 to 72 years) underwent 48 h ambulatory monitoring pre- and postoperatively. Additionally 15 patients with hypertrophic non-obstructive cardiomyopathy (HNCM) were studied. Mean age was 49 +/- 11.5 years (range 28 to 69 years). Complex ventricular arrhythmias were defined as pairs (two consecutive QRS complexes) or non-sustained ventricular tachycardia (VT) (much greater than 3 QRS). Results in the operative group (HOCM) were as follows: The overall frequency of ventricular extrasystoles was low. There was no difference in the mean hourly ventricular extrasystole counts pre-operatively as compared to postoperatively. Thirteen patients had no pairs or VT pre- and postoperatively. Six patients had VT or pairs pre- and postoperatively. In five patients complex arrhythmias were detected only before surgery, whereas in another seven patients VT was first documented after operation. Overall, 11 patients had complex ventricular arrhythmias pre-operatively (pairs n = 3; VT n = 8, 3 to 8 QRS, rate 142 +/- 15 beats/min). Thirteen patients had complex ventricular arrhythmias after operation (pairs n = 4; VT n = 9, 4 to 10 QRS, rate 150 +/- 40 beats/min). Results in patients with HNCM were as follows: The overall frequency of ventricular extrasystoles was low, only three patients had a mean extrasystole count of more than 20 beats/h. Five patients had pairs and three patients ventricular tachycardia (5 QRS, rate 110 to 160 beats/min).(ABSTRACT TRUNCATED AT 250 WORDS)
肥厚型心肌病（HOCM）的外科治疗已被证明可改善症状和血液动力学状态。与接受药物治疗的HOCM患者相比，经主动脉瓣下肌切除术的预后似乎相对较好。复杂室性心律失常已被证明会影响预后。因此，开展了一项研究，以分析手术对HOCM患者室性心律失常的影响。31例患者（23例男性，8例女性），平均年龄44±13.6岁（13至72岁），在术前和术后进行了48小时动态心电图监测。另外还研究了15例肥厚型非梗阻性心肌病（HNCM）患者。平均年龄为49±11.5岁（28至69岁）。复杂室性心律失常定义为成对出现（两个连续的QRS波群）或非持续性室性心动过速（VT）（大于3个QRS波群）。手术组（HOCM）的结果如下：室性早搏的总体发生率较低。术前与术后每小时室性早搏平均计数无差异。13例患者术前和术后均无成对出现或室性心动过速。6例患者术前和术后均有室性心动过速或成对出现。5例患者仅在手术前检测到复杂心律失常，而另外7例患者室性心动过速首次记录在术后。总体而言，11例患者术前有复杂室性心律失常（成对出现n = 3；室性心动过速n = 8，3至8个QRS波群，心率142±15次/分钟）。13例患者术后有复杂室性心律失常（成对出现n = 4；室性心动过速n = 9，4至10个QRS波群，心率150±40次/分钟）。HNCM患者的结果如下：室性早搏的总体发生率较低，只有3例患者平均早搏计数超过20次/小时。5例患者有成对出现，3例患者有室性心动过速（5个QRS波群，心率110至160次/分钟）。（摘要截断于250字）
