尖端扭转型室性心动过速(附6例分析)

Ventricular Tachycardla with Twisting Spike, Torsade de Pointes (with Analysis of 6 Cases).

报告6例尖端扭转型室性心动过速(TDP)伴Q—T间期延长(0.56～0.72秒)。5例后天性者分别为高—冠心病2例,冠心病2例(1例为急性心肌梗塞),化脓性胆囊炎感染性休克1例。6例中5例伴有低血钾,3例演变为较长的室扑、室颤,需用电击去颤。5例属停歇依赖型,其中4例有Ⅲ度房室传导阻滞和不同程度窦性停搏,最长达12秒。1例为先天性长Q—T间期综合征,属肾上腺素依赖型。4例存活,2例死亡。

Six cases of torsade de pointes(TDP) with prolonged Q-T interval(0.56～0.72 seconds), are presented in this paper, of all the 6 patients(5 females, 1 male) ranging from 32 to 76 years of age, 5 cases are of acquired etiology (hypertensive coronary heart disease 2 cases, coronary heart disease 2 cases and purulent cholecystitis with infective shock 1 case), and the rest one case is a congenital prolonged Q-T interval syndrome. The ventricular tachycardia characterised by 200～250/min. with widened and deformed QRS complex whose points of R wave rotated around baseline every 5-10 beats happened in all 6 cases. Though the episode of ventricular tachycardia usually terminates simultaneously, 3 of the 6 cases developed lasting ventricular flutter or fibrillation, making the electric defibrillation necessary. After the treatment, 4 patients suvived and 2 died Finally, detail discussions on the etiology, pathogenetic mechanisms, warning signs and treatment of this disease were presented.