预激合并室上性快速心律失常所致的心肌病

Tachycardiomyopathy induced by recurrent tachycardia in patients with Wolff Parkinson White syndrome

４例因长期心动过速而发生心功能障碍的患者，经检查除外其他器质性心脏病后，予以射频消融终止心动过速。分别于术后２周及４个月行超声心动图检查，结果显示ＬＶＥＦ、ＬＶＥＤＤ、ＬＶＥＳＤ均较术前有明显改善。提示对于长期快速心律失常患者，即使在心功能受损的情况下，也应积极治疗，以便改善患者预后。

The existence of cardiomyopathy (CM) caused by persistent abnormal high heart rate is well documented. Our aim was to confirm that cardiac dilation and symptoms of heart failure could be re regressive after successful radiofrequency catheter ablation (RFCA) controlling tachycardia. Four patients with atrioventricular reentrant tachycardia (AVRT) caused by an accessory pathway were seen with symptoms or echocardiographic sign of CM. Two of them were in NYHA functional class II, one was in class III and one in class IV. All patients underwent RFCA of the accessory pathway. Before ablation the mean left ventricular ejection fraction (LVEF) was 38.2%, the left ventricular end diastolic diameter (LVEDD) 61.3mm and the left ventricular end systolic diameter (LVESD) 50mm. A mean follow up of 4 months after the procedure the mean LVEF increased to 61.2%, LVEDD decreased to 52.5mm, LVESD decreased to 35.5mm. Three patients were in functional class I, one was in class II. The improvement of the left ventricular systolic function occurred earlier than that of diastolic function. Regression of the cardiomyopathy like syndrome after successful control of the arrhythmia confirms the existence of tachycardiomyopathy. Persistent AVRT patients with cardiac dysfunction is an indication for RFCA.