Mühler E G, Kienast W, Turniski-Harder V, von Bernuth G
Department of Pediatric Cardiology, RWTH Aachen, Germany.
Eur Heart J. 1994 Jul;15(7):915-21. doi: 10.1093/oxfordjournals.eurheartj.a060610.
Twenty-one patients, aged from 1 day to 16 years (median 8 months), with primary cardiac tumours, were studied with regard to the occurrence of arrhythmias. Standard electrocardiogram (ECG) was available in 20 cases and 24 h ambulatory ECG in 19; nine patients had prospective follow-up investigations (mean follow-up time 3.0 years). Standard ECG revealed preexcitation in two and arrhythmias in six patients. Ambulatory ECG disclosed seven patients with significant rhythm disturbances and in four of these, the arrhythmia was the symptom leading to the diagnosis of a cardiac tumour. Three patients were symptomatic from arrhythmia and two of them were successfully treated with antiarrhythmic agents. The remaining patient with recurrent life-threatening ventricular tachycardia underwent partial resection of a large left ventricular fibroma; no further episodes of ventricular tachycardia were observed postoperatively. Only one of the 15 patients with cardiac rhabdomyomas required antiarrhythmic therapy. None of the nine patients prospectively followed developed arrhythmias requiring therapy. The present data underline the fact that infants and children with cardiac tumours rarely need surgery because of arrhythmia resistant to medical treatment. As far as possible, conservative management is indicated in infants with suspected rhabdomyomas.
对21例年龄从1天至16岁（中位年龄8个月）的原发性心脏肿瘤患者进行了心律失常发生情况的研究。20例患者有标准心电图（ECG）记录，19例有24小时动态心电图记录；9例患者进行了前瞻性随访研究（平均随访时间3.0年）。标准ECG显示2例患者有预激，6例患者有心律失常。动态心电图显示7例患者有明显的节律紊乱，其中4例患者的心律失常是导致心脏肿瘤诊断的症状。3例患者因心律失常出现症状，其中2例经抗心律失常药物治疗成功。其余1例反复发生危及生命的室性心动过速的患者接受了左心室大纤维瘤部分切除术；术后未再观察到室性心动过速发作。15例心脏横纹肌瘤患者中只有1例需要抗心律失常治疗。前瞻性随访的9例患者均未发生需要治疗的心律失常。目前的数据强调了这样一个事实，即患有心脏肿瘤的婴幼儿和儿童很少因药物治疗无效的心律失常而需要手术。对于疑似横纹肌瘤的婴儿，应尽可能采取保守治疗。
