[SCD-FORUM] 38E 致心律失常性右室发育不良病人的室上性心律失常 ――Fontaine医生

[SCD Symposium]

38E 致心律失常性右室发育不良病人的室上性心律失 
常 ――Fontaine医生
        1991年我们小组报道了在明显致心律失常性右室 
发育不良患者中室上性心律失常的发生率。在我们回 
顾的患者群体当中有25％的患者被观察到有室上性心 
律失常。自从那时起，我们观察到这些心律失常可以 
是致心律失常性右室发育不良患者首先出现的症状。 
这些患者中有些没有心室扩张也没有三尖瓣返流。因 
此提示这种疾病可能累及到心房。右心室组织学不是 
很清楚因为它包含了生理性脂肪组织和纤维化。致心 
律失常性右室发育不良患者心房肌间缝隙连接的改变 
我们尚未研究。植入辅助装置的致心律失常性右室发 
育不良患者中，特别是那些有房室快速传导（Wenkeback 
超过200 bpm）者，房性心律失常也是引起不规律休克 
的原因。我建议不要遗漏评估房室传导及心房易感性 
的全面性电生理检查。

Guy Hugues Fontaine医生

Dr. Sergio Dubner
科委会主席

Dr. Edgardo Schapachnik
组织会主席
袁奕译


38E SV arrhythmias in patients with ARVD. Dr. Fontaine
The incidence of SV arrhythmias in patients with obvious ARVD has
been reported by our group in 1991.
It was observed in 25 % of our cohort of retrospective patients.

Since then we have observed that these arrhythmias can be the first
presenting symptom of patients with ARVD. Some of these patients have  
no ventricular dilatation and no  tricuspid regurgitation. Therefore  
it is possible to suggest that the  disease may have some extension  
on the atrium. Histology of RV is not  clear because it contains  
physiologically fat and fibrosis. We have  not studied yet alteration  
of gap junctions in atrial muscle in ARVD.

Atrial arrhythmias is also a cause of inappropriate shocks in ARVD
patients with the device especially those with fast AV conduction
(Wenkeback above 200 bpm).

I have suggested not to miss a complete EPS evaluating AV conduction
and atrial vulnerability

Am J Cardiol. 1991 May 15;67(13):1153.
Frequency of supraventricular tachyarrhythmias in arrhythmogenic right
ventricular dysplasia.
Tonet JL, Castro-Miranda R, Iwa T, Poulain F, Frank R, Fontaine GH.
Service de Rytmologie et de Stimulation Cardiaque, Hopital Jean
Rostand, Ivry,
France.
Guy Hugues Fontaine

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee