尖端扭转型室性心动过速的快速识别和治疗

The rapid identification and therapy of torsade de points

目的:分析快速识别和治疗尖端扭转性室性心动过速(Tdp)的方法及疗效。方法:对36例Tdp的临床资料、心电图特征及治疗情况进行分析。结果:先天性长QT间期综合征(LQTS)伴发Tdp者3例,获得性长QT间期致Tdp(LQTT)者29例,伴有极短联律间期的Tdp4例。先天性LQTS治疗的重点是使用β受体阻滞剂;获得性LQTT治疗的重点是去除病因,增快心率,纠正心室复极异质性;伴极短联律间期的Tdp治疗的重点是使用钙拮抗剂。结论:尽快获取病史和诱发因素,详细甄别心电图和针对性治疗,对Tdp的快速识别和及时处理具有重要意义。

AIM:To discuss the method of rapid identification and therapy of Torsade de points(Tdp). METHODS: The clinical data, ECG characteristics and therapeutics course in 36 Tdp patients were analysed . RESULTS: Of all the cases,3 were herited LQTS with Tdp, 29 were acquired LQTT and 4 were Tdp with very short coupling intervals. The emphasis in the therapy of inherited LQTS was the use of β-adrenoceptor blocking agents. The emphasis in the therapy of ALQTT was to get rid of its pathogeny, to accelerate HR, and to correct the ventricular repolarization heterogenesis .The emphasis in the therapy of Tdp with very short coupling intervals was the use of Calcium channel antagonists. CONCLUSION: For the rapid identification and timely therapy of Tdp, it is of great significance to get the medical history and inducement as soon as possible, to identify the ECG in detail and to treat the patients pertinently.