Rumoroso J R, Bodegas A, Subinas J, Montes P M, Sanz R, Rodrigo D, Barrenetxea J I
Servicio de Cardiología, Hospital de Cruces, Baracaldo, Vizcaya.
Rev Esp Cardiol. 1994 Sep;47(9):633-5.
We present a 36-year-old male without overt cardiac disease who suffered, since he was 15 years old, from sustained monomorphic ventricular tachycardia of left bundle branch block with a right axis, lasting for several hours; sometimes, syncope was a clinical form of manifestation. Electrophysiologic study, twenty-four hours Holter recording, cardiac catheterization and blood analysis were not useful in order to find its etiology. Efficacy of different drugs, like Mexiletil, Amiodarone, Atenolol and Verapamil (at a dose of 240 mg/day) were tested through multistaged graded-treadmill stress-testing using the Bruce protocol. Ventricular tachycardia was suppressed by administration of Lidocaine. Oral verapamil given at a dose of 360 mg/day prevented the induction of the arrhythmia, the efficacy was tested with maximal treadmill exercise and twenty-four hours Holter recording.
我们报告一名36岁男性,无明显心脏病史,自15岁起患有持续单形性室性心动过速,呈左束支传导阻滞伴电轴右偏,持续数小时;有时晕厥是其临床表现形式。电生理研究、24小时动态心电图记录、心脏导管检查和血液分析均无助于查明其病因。通过采用布鲁斯方案的多级递增式跑步机压力测试,对不同药物(如美西律、胺碘酮、阿替洛尔和维拉帕米(剂量为240毫克/天))的疗效进行了测试。静脉注射利多卡因可抑制室性心动过速。口服维拉帕米剂量为360毫克/天可预防心律失常的诱发,通过最大跑步机运动和24小时动态心电图记录对疗效进行了测试。