TACHYCARDIA-INDUCED CARDIOMYOPATHY - A REVERSIBLE FORM OF LEFT-VENTRICULAR DYSFUNCTION
TACHYCARDIA-INDUCED CARDIOMYOPATHY - A REVERSIBLE FORM OF LEFT-VENTRICULAR DYSFUNCTION
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DOI：
10.1016/0002-9149(86)90836-2
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发表时间：
1986-03-01
影响因子：
2.8
通讯作者：
GERMAN, LD
中科院分区：
文献类型：
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作者：
PACKER, DL;BARDY, GH;GERMAN, LD
8例患者，年龄5至57岁，患有不受控制的症状性心动过速2.5至41年（平均15年）和显著的左心室（LV）功能障碍，无任何其他明显的潜在心脏疾病进行了评价。7例患者持续心动过速0.5 ~ 6.0年（平均2.1年）。1例患者有异位房性心动过速，7例患者有参与往复性心动过速的房室旁道。6例患者接受了手术治疗; 1例患者的异位病灶被消融，5例患者的旁路被分离。1例患者接受了希氏束开放消融术，1例患者接受了房室传导系统闭胸消融术。5例患者的心肌活检标本均未得到特异性诊断。治疗前放射性核素血管造影显示平均射血分数（EF）为19 ± 0.5。9%（范围10 - 35%）。心动过速控制后，8例患者中有6例在休息时左室功能明显改善，另外1例患者在运动时左室功能明显改善。EF增加至33 ±。治疗后8天平均17%（范围16 - 56%），治疗后45 ± 10%（范围16 - 56%）。15%（范围22 - 67%），晚期随访3.5 ±。40个月（平均17个月）后（p < 0.005）。7例患者在矫正手术后11至40个月（平均22个月）仍无症状，并已恢复正常活动。这些结果表明，慢性不受控制的心动过速可能会导致显著的LV功能障碍，在某些情况下，在心律失常得到控制后，LV功能障碍是可逆的。
Eight patients, aged 5 to 57 years, with uncontrolled symptomatic tachycardia for 2.5 to 41 years (mean 15) and significant left ventricular (LV) dysfunction in the absence of any other apparent underlying cardiac disease underwent evaluation. Incessant tachycardia was present for 0.5 to 6.0 years (mean 2.1) in 7 patients. One patient had an ectopic atrial tachycardia and 7 patients had an accessory atrioventricular pathway that participated in reciprocating tachycardia. Six patients underwent surgery; the ectopic focus was ablated in 1 patient had an accessory pathway was divided in 5 patients. One patient underwent open ablation of the His bundle and 1 patient underwent closed-chest ablation of the atrioventricular conduction system. Myocardial biopsy specimens were obtained from 5 patients, none of which yielded a specific diagnosis. Pretreatment radionuclide angiography demonstrated a mean ejection from (EF) of 19 .+-. 9% (range 10 to 35%). Following tachycardia control a marked improvement in LV function was noted in 6 of 8 patients at rest and in 1 additional patient during exercise. The EF increased to 33 .+-. 17% (range 16 to 56%) an average of 8 days after treatment and to 45 .+-. 15% (range 22 to 67%) at late follow-up 3.5 .+-. 40 months (mean 17) later (p < 0.005). Seven patients remain asymptomatic 11 to 40 months (mean 22) after the corrective procedure and have resumed normal activities. These findings suggest that chronic uncontrolled tachycardia may result in significant LV dysfunction, which is reversible in some cases after control of the arrhythmia.