儿茶酚胺敏感性多形性室性心动过速患者的平板运动试验特点分析

Exercise-stress test characteristics of catecholaminergic polymorphic ventricular tachycardia

目的研究儿茶酚胺敏感性多形性室性心动过速(CPVT)患者的平板运动试验特点。方法回顾性分析2006年9月至2014年3月在北京大学人民医院心内科临床诊断为CPVT的15例患者(其中男性9例,60.0%)的平板运动心电图资料。结果 (1)服用药物前,15例患者行平板运动试验均诱发出室性心律失常,阈值心率为(122.3±26.1)次/min,其中9例(60.0%)记录到特征性双向性室性心动过速,6例(40.0%)记录到双向性室性心动过速和多形性室性心动过速;(2)同时,8例患者(53.3%)记录到运动后的房性心律失常,且房性期前收缩阈值心率明显低于室性期前收缩[(91.5±26.3)次/min比(115.2±18.5)次/min,P=0.003];(3)15例患者在良好的监测下,平板运动试验安全性可靠。结论平板运动试验可安全有效诱发室性心律失常,对于CPVT的诊断有重要价值。

Objective To investigate the characteristics of exercise-stress test in catecholaminergic polymorphic ventricular tachycardia（ CPVT） patients. Methods Exercise-stress test data of 15 CPVT patients（ 9 male,60. 0%）,diagnosed in the Department of Cardiology,Peking University People＇s Hospital between September 2006 and March 2014,were reviewed and analyzed retrospectively. Results（ 1）Without any medication, 15 patients underwent exercise-stress test showing induction of ventricular tachycardia,and premature ventricular contractions threshold was（ 122. 3 ± 26. 1） beats /min. The morphology of CPVT was bidirectional（ 9 /15,60. 0%）,polymorphic and bidirectional（ 6 /15,40. 0%）;（ 2） Meanwhile,atrial arrhythmia were recorded in 8 patients（ 8/15,53.3%） and premature atrial contractions（ PACs） threshold was significantly lower than premature ventricular contractions（ PVCs）[（ 91.5 ±26.3） bpm vs.（ 115.2 ±18.5）,P =0.003];（ 3） Under well controlled conditions,exercisestress tests were performed safely. Conclusions Ventricular arrhythmias can be triggered by exercise-stress test effectively and safely in CPVT patients. Exercise-stress test has important value in diagnosing CPVT.