致心律失常性右心室心肌病临床分析

Clinical analysis of arrthythmogenic right ventricular cardiomyopathy

目的 :分析致心律失常性右心室心肌病的临床特点。方法 :将 2 3例致心律失常性右心室心肌病患者常规行超声心动图、心电图、胸片、动态心电图、心房调搏及心内电生理检查。结果 :本组 2 3例患者多有晕厥发作 ,频发室性早搏 (95 7% ) ,右心室源性短阵室速 (87% ) ,心电图多为右束支传导阻滞 (87% ) ,超声心动图右心室内径为 (5 0 1± 8 83)mm ,右心房内径为 (48± 8 79)mm ,右心室与左心室舒张末期内径之比为 1 0 9,右心功能减退 ,射血分数 (EF)为(0 32 5± 0 0 90 2 )。结论 :致心律失常性右心室心肌病 ,多有发作性晕厥 ,右束支传导阻滞 ,频发室早及左束支传导阻滞型室速 ,右心室、右心房增大 ,右心室功能减退 。

Objective To investigate the clinical features of arrthythmogenic right ventricular cardiomyopathy (ARVC), and to evaluate the diagnosis of ARVC. Methods Twenty three cases of ARVC underwent ECG, chest x ray, Holter, transesophageal atrial pacing (TEAP) and intracardiac electrophysiological examination. Results A syncope attack occurred; the percentage of frequent ventricular premature beats was 95.7%, salvos of the right ventricular originated ventricular tachycardia (VT) was 87%, and the right bundle branch block (RBBB) demonstrated by ECG was 87%; UCG showed that the enlarged right ventricular diametric was (50.1±8.83)mm, and the right atrium diametric was (48±8.79)mm; the ratio of right ventricular diametric to left ventricular diametric in the end diastolic period was 1.09. The right ventricular function [ejection fraction: (0.325±0.0902)] decreased, which was confirmed by echocardiogram. Conclusion The diagnosis of ARVE can be established on the basis of the repeated syncope attack; RBBB, frequent ventricular premature beats, VT of LBBB patterms, an enlarged right heart and decreased right ventricular function can be found; the ratio of right ventricular dimaetric to left ventricular diametric increases in the end diastolic period.