特发性右室流出道心律失常患者J波的发生率及其临床特征

Prevalence and characteristics of idiopathic right ventricular outflow tract arrhythmias associated with J-waves

目的调查J波在特发性右室流出道室性心动过速或室性早搏(RVOT-VT/PVCs)病人的发生率及其临床特征。方法该研究纳入143例特发性RVOT-VT/PVCs的患者和285例年龄和性别匹配的健康体检者作为对照组。评估、比较两组间J-波的发生率。依据J波的存在与否,将患者分为伴有J波的RVOT-VT/PVCs组(J-VT/PVCs组)和不伴有J波的RVOT-VT/PVCs组(non-J-VT/PVCs组),对两组的临床和电生理数据进行比较。结果与对照组比较,J波在特发性RVOT-VT/PVCs患者中更为常见(39.9%vs 16.1%,P<0.01)。与non-J-VT/PVCs组比较,J-VT/PVCs组持续性VT、晕厥有较高的发生率,分别为24.6%vs 4.7%;26.3%vs 2.3%,P均<0.01。而且VT的周期更短[(304±56)ms vs(350±56)ms,P<0.01]。两组中无心室颤动或心脏猝死发生。结论特发性RVOT-VT/PVCs患者,有较高的J波发生率;有J波的患者伴随有较严重的心律失常。

Objective To investigate the prevalence and characteristics of idiopathic ventricular tachycardia（VT） or premature ventricular contraction（ PVCs）, originating from right ventricular outflow （RVOT） （RVOT-VT/PVCs） associated with J-waves. Methods The study enrolled 143 consecutive idiopathic RVOT-VT/PVCs patients and 285 age-and gender-matched control subjects. The prevalence of J-waves was assessed in each cohort, and the clinical and electrophysiological data were compared between the RVOT-VT/PVCs patients with J-waves（ J-VT/PVCs group） and those without （non-J- VT/PVCs group）. Results J-waves were more common among patients with idiopathic RVOT-VT/PVCs than among the matched control subjects （39.9% vs 16. 1% ,P〈0.01 ）. The J-VT/PVCs group had a higher incidence of sustained VT （24.6% vs 4.7%, P〈0.01 ）, more episodes of syncope （26.3% vs 2.3%, P〈0.01 ）, and shorter VT cycle length [ （304±56）ms vs （350±56） ms, P〈0.01 ] than did the non-J-VT/PVCs group. However, no patients demonstrated any ventricular fibrillation （VF） or cardiac sudden death in either group. Conclusions There is a high prevalence of J- waves in the idiopathic RVOT-VT/PVCs patients. Patients with idiopathic RVOT arrhythmias associated with J-waves might have a more enhanced arrhythmogenicity than those without J-waves.