极短联律间距室性心动过速临床分析

Clinical Analysis of Polymorphic Ventricular Tachycardia with Extremely Short Coupling Interval

目的:探讨极短联律间距室性心动过速的治疗。方法:本组10例,男4例,女6例,年龄16～62岁,平均42±12岁。本类室性心动过速以正常QT伴极短联律间距(平均300ms)为心电图特征,临床上反复发作晕厥,无器质性心脏病。通常对Ⅰ、Ⅱ、Ⅲ类抗心律失常药物无效,但维拉帕米治疗有效。结果:维拉帕米静脉注射能终止本类室性心动过速,用量5～39g,平均22mg。结论:维拉帕米治疗本类室性心动过速安全、有效,使用剂量宜个体化。

Purpose:To study the emergency treatment of polymorphic ventricular tachycardia (VT) with extremely short coupling interval. Methods: 10 cases (4 males and 6 females mean aged 42 ±12 rage from 16~ 62 years) with polymorphic VT caused by the short coupling interval premature ventricular contraction (PVC) were enrolled in this study. The clinical features included that: (1) The coupling interval of single PVC and PVCs triggering TV was extremely short (mean 300ms). (2)Q-T interval wane pattern during sinus rhythm were normal. (3)The long Q-T syndromes in clinical manifestation. (4)No obvious heart structure abnormality was found. (5) Refractory to conventional antiarrhythmic but intravenous verapamil might be very effective. Reasults: Polymorphic VT with extrctively short coupling interval could be effectively terminated by intravenous verapamil in all of the cases. The average effective dose was 22mg (5~38mg). Conclusion: Intravenous vera-pamil has a high efficacy and safety for polymorphic TV with extremity shirt coupling interval. The dosing of verapamil varies according to individuals.