Grenadier E, Alpan G, Maor N, Keidar S, Binenboim C, Margulies T, Palant A
Am J Cardiol. 1984 May 1;53(9):1280-3. doi: 10.1016/0002-9149(84)90079-1.
Polymorphous ventricular tachycardia (VT) is thought to be uncommon in acute coronary heart disease, but its prevalence has not been determined. Seven hundred seventy-one consecutive patients admitted with acute myocardial infarction (MI) were reviewed for the occurrence of this arrhythmia. Nine patients (1.2%) had polymorphous VT. No patient had any of the predisposing factors previously associated with polymorphous VT. The arrhythmia was resistant to multiple drugs, and repeated cardioversion was effective in only 3 patients. Overdrive pacing was ineffective in the 3 patients in whom it was attempted. Verapamil was effective in 3 of 4 patients in whom it was tried. Six patients with polymorphous VT died during hospitalization; the remaining 3 died within 6 months of discharge. It is concluded that, when compared with regular VT, polymorphous VT in MI carries a poor prognosis. When the arrhythmia occurs in the context of acute ischemia, it appears to be more difficult to treat compared with its occurrence due to other predisposing factors. Verapamil, not usually indicated for ventricular arrhythmias, should be tested in a therapeutic trial.
多形性室性心动过速（VT）在急性冠心病中被认为并不常见，但其患病率尚未确定。对771例连续收治的急性心肌梗死（MI）患者进行了该心律失常发生情况的回顾性研究。9例患者（1.2%）发生了多形性室性心动过速。没有患者具有先前与多形性室性心动过速相关的任何易感因素。该心律失常对多种药物耐药，重复电复律仅对3例患者有效。超速起搏对尝试该方法的3例患者无效。维拉帕米对4例尝试使用的患者中的3例有效。6例多形性室性心动过速患者在住院期间死亡；其余3例在出院后6个月内死亡。结论是，与规则性室性心动过速相比，心肌梗死中的多形性室性心动过速预后较差。当心律失常发生在急性缺血背景下时，与由其他易感因素引起的情况相比，似乎更难治疗。维拉帕米通常不用于室性心律失常，应在治疗试验中进行测试。
