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Kokyu to Junkan Volume 32, Issue 8 （August 1984）

呼吸と循環 32巻8号（1984年8月発行）

Japanese English

研究

小児期慢性反復性心室頻拍の検討—電気生理学および病理学的検討 Studies of recurrent sustained ventricular tachycardia (RSVT) in children:Investigations by electrophysiologic and histopathologic method 米坂勧 ¹ , 上村健三 ¹ , 五十嵐勝朗 ¹ , 桜井勇 ² Susumu Yonesaka ¹ , Kenzo Kamimura ¹ , Katuro Igarashi ¹ , Isamu Sakurai ² ¹弘前大学医学部小児科 ²日本大学医学部病理学 ¹Department of Pediatrics, Hirosaki University School of Medicine ²Department of Pathology, Nippon University School of Medicine pp.811-816

発行日 1984年8月15日 Published Date 1984/8/15

DOI https://doi.org/10.11477/mf.1404204494

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Abstract 文献概要
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　小児の心室性頻拍症（ventricular Tachycardia：VT）ことに慢性反復性心室性頻拍（Recurrent SustainedVentricular Tachycardia：RSVT）は稀とされてきたが，近年小児不整脈に対する関心が高まってきたことや，学童心電図検診の普及につれ，それほど稀なものではなくなると思われる。

　著者は3例のRSVTを呈した症例に対して，電気生理学的および内膜心筋生検による病理学的検討を加え興味ある知見を得たので報告する。

Three pediatric patients with recurrent sustained ventricular tachycardia, which is reported to be a relatively rare arrhythmia in infancy and child-hood, were evaluated by electrophysiologic and histopathologic method. Electrophysiologic studies revealed microreentrant tachycardia in all three patients.

Two of them were performed programmed ven-tricular stimulation to evaluate the effectiveness of antiarrhythmic drugs. Ventricular tachycardia was easily induced by the programmed vetricular stimulus method at the critical tachycardia zone in the two patients. After the administration of an-tiarrhythmic drugs intravenously, tachycardia zone changed significantly though complete dis-appearance of tachycardia zone was obtained. Following oral administration of antiarrhythmic drugs evaluated, frequent episodes of ventricular tachycardia diminished markedly. Programmed ventricular stimulation has widely used to evaluate ventricular tachycardia in adult, but only a few trials has been performed in the children with ventricular tachycardia. This method is easy and safe for infants and childen. Histopathologic findings by endomyocardial biopsy were as follows : Two of them revealed the findings of suggestive cardio-myopathy, and one showed the findings of myocar-ditis.

Conclusion : 1) Electrophysiologic studies, especially programmed ventricular stimulation, was also as useful method to evaluate effective antiarrhythmic drugs in the children with RSVT as in adult with chronic ventricular tachycardia.2) His topathologic studies by endornyocardial biopsy should be tried in the children who show recurrent ventriclar tachycardia or dysrhythmia complexes.