Non-Sustained, Symptomatic Ventricular Tachycardia: A Case Report and Literatures Review

非持續性具症狀之心室心搏過速：病例報告及文獻回顧

歐子銘(Tzu-Ming Ou) ； 黃世鐘(Shih-Chung Huang) ； 項正川(Jeng-Chuan Shiang) ； 王怡誠(Yi-Chen Wang)

《重症醫學雜誌》 12卷4期 (2011/12) Pp. 182-192

https://doi.org/10.30035/TCCM.201112.0005

摘要

非持續性心室心搏過速臨床上很常見，但了解的人卻不多。具有非持續性心室心搏過速的病人輕微者可以無症狀，嚴重者卻有猝死的可能。預後跟合併的心臟疾病有關。不良的預後常見於運動誘發之非持續性心室心搏過速、急性心肌梗塞24小時過後、慢性缺血性心臟病及左心室射出分率小於40%合併有或無於心臟電生理檢查誘發出非持續性心室心搏過速、年輕人之肥厚性阻塞性心肌病變。藥物治療包含乙型交感神經阻斷劑及amiodarone，而植入式心臟整流去顫器及射頻燒灼術適用於某些病人。我們報告一個71歲女性合併有暈厥及心悸的症狀，24小時心電圖診斷非持續性心室心搏過速。經射頻燒灼術及藥物治療後病情獲得穩定控制。希望藉由這個病例讓大家更加認識這個疾病。

關鍵字

非持續性心室心搏過速 ； 左心室射出分率

並列摘要

Non-sustained ventricular tachycardia (NSVT) is commonly seen but poorly understood. Patients with NSVT might be asymptomatic or encountered sudden cardiac death. The prognosis depends on what the concomitant heart disease is. Poor prognosis were found in patient with NSVT during or post exercise; acute myocardial infarction more than 24 hours; chronic ischemic heart disease with left ventricular ejection fraction (LVEF) below 40% with/without inducible sustained ventricular tachycardia in electrophysiology testing; and hypertrophic obstructive cardiomyopathy in the young. Medical therapy including beta-blockers and class III antiarrhythmic agents, while implantable cardiac defibrillators (ICD) and radiofrequency ablation are indicated in certain patients. Here, we report a case that had near syncope and palpitation with NSVT on 24-hours electrocardiography, finally received ablation and antiarrhythmic therapy. No more arrhythmia was found during out patient department follow up.

並列關鍵字

Non-sustained ventricular tachycardia (NSVT) ； Left ventricular ejection fraction (LVEF) ； Right ventricular outflow tract (RVOT) ； Implantable cardioveter defibrillator (ICD)