Dhala A, Lewis D A, Garland J, Pelech A N
Electrophysiology Laboratory, Children's Hospital of Wisconsin, Milwaukee, USA.
Pacing Clin Electrophysiol. 1996 Nov;19(11 Pt 1):1652-4. doi: 10.1111/j.1540-8159.1996.tb03195.x.
Incessant VTs in infancy are often poorly tolerated. Response to conventional antiarrhythmic therapy is disappointing. The present case involves a 3-week-old infant with an incessant VT of a left bundle branch block, and normal axis morphology. This tachycardia was inducible with both atrial and ventricular pacing, but not by premature stimulation. Tachycardia persisted despite treatment with adenosine, esmolol, procainamide, and flecainide. Intravenous verapamil suppressed tachycardia and prevented inducibility, and no further recurrences were seen on oral verapamil. This case suggests that some incessant VTs in infancy may be due to calcium channel related afterdepolarizations or triggered activation.
婴儿期的持续性室性心动过速（VT）通常耐受性较差。对传统抗心律失常治疗的反应令人失望。本病例为一名3周大的婴儿，患有左束支传导阻滞且电轴形态正常的持续性室性心动过速。这种心动过速在心房和心室起搏时均可诱发，但不能通过过早刺激诱发。尽管使用了腺苷、艾司洛尔、普鲁卡因胺和氟卡尼进行治疗，心动过速仍持续存在。静脉注射维拉帕米可抑制心动过速并防止其诱发，口服维拉帕米后未见进一步复发。该病例表明，婴儿期的一些持续性室性心动过速可能与钙通道相关的后除极或触发激动有关。
