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目的探讨儿童特发性室性心动过速(IVT)的临床诊治特点。方法对18例诊断为IVT的患儿,就其临床表现、心电图特征、部分患儿的运动试验(Brace方案)检查结果及临床治疗转归进行分析。结果1.儿童IVT主要起源于右心室流出道及左心室间隔;2.37%右室流出道IVT患儿有明显的心悸主诉,且与运动、情绪、感染等有关;90%左室IVT有心悸、面色苍白;3.右室流出道IVT常伴有频发室性早搏,VT多数为非持续性VT,运动试验VT的诱发率高;左室IVT均呈持续性VT发作,能为心房或心室的程序刺激所诱发;4.腺苷、β受体阻滞剂、钙通道阻滞剂能较好地防治IVT的发生;5.大多数儿童IVT具有很好的预后,射频消融能根治IVT。结论儿童IVT是发生于无器质性心脏病证据或致心律失常因素的一种VT,预后良好。有部分病人在疾病的某个过程需要药物的防治,其中大部分可以发展为不用药,甚至痊愈。对于症状严重、发作频繁的患儿,射频消融可使IVT得以根治。
Objective To investigate the clinical diagnosis and treatment of idiopathic ventricular tachycardia (IVT) in children. Methods 18 children diagnosed as IVT were enrolled in this study. Their clinical manifestations, electrocardiographic features, the results of some children ’s motor tests (Brace regimen) and clinical outcomes were analyzed. IVT children with IVT mainly originated from the right ventricular outflow tract and left ventricular septum; 2.37% IVT children with right ventricular outflow tract had obvious palpitations complaints, and related to exercise, emotion, infection, etc .; 90% of left ventricular IVT palpitations, Pale; 3. Right ventricular outflow tract IVT often accompanied by frequent ventricular premature beats, VT most of the non-sustained VT, exercise test VT induced rate of high; left ventricular IVT were persistent VT attack can be atrial or ventricular ; 4 adenosine, β blockers, calcium channel blockers can better prevent the occurrence of IVT; 5. Most children with IVT have a good prognosis, radiofrequency ablation can cure IVT. Conclusions IVT in children is a VT with evidence of or evidence of arrhythmic events without organic heart disease and has a good prognosis. Some patients in the disease process requires the prevention and treatment of drugs, most of which can develop without medication, and even recovered. For patients with severe symptoms and frequent episodes, radiofrequency ablation allows IVT to be cured.