非器质性心脏病室速的认识及评价

Eualuation of Ventricular Tachycardia with Non-organic Heart Disease

目的：探讨非器质性心脏病室连的临床表现、心电图特征、治疗反应及预后。方法：对心电图和间断24小时DCG监测、随访的22例非器质性心脏病室连病例进行回顾性分析。结果：本组病例有如下共同特点：年纪轻，无器质检心脏病证据，室速反复发作的时间长，但症状轻，发作时无血流动力学障碍，预后良好。心电图QRS渡时限均≤0.12s，QRS呈右束支阻滞伴电轴左偏或右偏和左束支阻滞图型，室速发作时QRS形态呈单形性室速，偶见房室分离、心室夺获和（或）室性融合波，复律后下壁或前壁T波倒置。中止发作治疗：QRS呈LBBB型者对β阻滞剂敏感；QRS呈RBBB型者对维拉帕米敏感；心律平时二者均敏感。结论：准确地识别此类室速，有助于正确诊断和恰当治疗。

Objective: To investigate the clinical manifestations. ECG Feature, treatment reaction and prognosis of ventricular tachycardia non- organic heart disease, methods: To study 22 cases of ventricular tachycardia with non-organic heartdisease who monitored by ECG and interval 24 hours DCg and were visited later. Results: The common features of this group ofcases were as follows: they were youn, with no evidence of organic heart disease, the time of attack of ventricular tachycardiawas long but there were slight symptoms and without obstruction of blood kinetics. Prognosis was favourable. QRS time intervalswere<0.12s. QRS waves presented the pottern of RBBB accompanied with left or right slanting of electric axle and the patternof LBBB. When there was attacking of ventricular tachycardia, QRS waves presented with single form of ventricular tachycardia,artrioventricular divorce, ventricular captures and/or ventricular mixing wave could be seen accidentally. T waves of lower of front wall were inverted for the recovering of tachycardia, Cases with LBBB pattern of QRS waves were sensitive to β-receptorblockres. Cases with RBBB pattem of QRS waves were sensitive to Verapame. Baxarytmon was effective on both of these twotypes of arrhythmia. Conclusions: Accurate discerning of this type of ventricular tachycardia was helpful on correct diagnosis and appropriate treatment and avoiding the abuse of anti-arrhythmia drugs which could bring about arrhythmia.