Reek S, Klein H, Huth C
Klinik für Kardiologie, Angiologie, Pulmologie, Universitätsklinik, Otto-von-Guericke, Madeburg.
Z Kardiol. 1995;84 Suppl 2:163-7.
We report on a 45-year-old man with a 4-year-old myocardial infarction and a history of recurrent syncopes. A monomorphic ventricular tachycardia was inducible during electrophysiologic study. After coronary bypass-grafting ventricular tachycardia was no longer inducible. The patient is now, 6 months after surgery, and without antiarrhythmic drugs, free from recurrence of syncope and has had no spontaneous tachycardia event. Treatment with antiarrhythmic drugs, endocardial resection, and the implantable cardioverter-defibrillator are well established approaches to fight sudden cardiac death. The role of coronary artery bypass-grafting alone in the prevention or suppression of malignant ventricular arrhythmias is debatable, especially in cases of monomorphic ventricular tachycardia. Some of these high-risk patients may well be protected by coronary artery bypass grafting alone.
我们报告了一名45岁男性，他有4年心肌梗死病史且有反复晕厥史。在电生理研究中可诱发单形性室性心动过速。冠状动脉搭桥术后，室性心动过速不再可诱发。该患者目前术后6个月，未服用抗心律失常药物，未再发生晕厥，也未出现自发的心动过速事件。抗心律失常药物治疗、心内膜切除术和植入式心脏复律除颤器是防治心脏性猝死的常用方法。单纯冠状动脉搭桥术在预防或抑制恶性室性心律失常中的作用存在争议，尤其是在单形性室性心动过速的病例中。其中一些高危患者可能仅通过冠状动脉搭桥术就能得到保护。
