2024 年第 4 期 第 19 卷

特发性室性期前收缩评估和管理的研究进展

Advances in research on evaluation and management of idiopathic premature ventricular contractions

作者：杨扬李梦梦韩康宁龙德勇

英文作者：Yang Yang Li Mengmeng Han Kangning Long Deyong

单位：首都医科大学附属北京安贞医院心内科国家心血管疾病临床医学研究中心，北京100029

英文单位：Department of Cardiology Beijing Anzhen Hospital Capital Medical University National Clinical Research Center for Cardiovascular Diseases Beijing 100029 China

关键词：特发性室性期前收缩；室性期前收缩诱发性心肌病；室性期前收缩负荷

英文关键词：Idiopathicprematureventricularcontractions；Prematureventricularcontractioninducedcardiomyopathy;Prematureventricularcontractionburdens

• 摘要：

• 特发性室性期前收缩是临床常见的心律失常类型，既往观点认为此类疾病多数预后良好。但近年来人们发现这一过去被普遍认为是良性、无需过多干预的心脏节律异常，与部分患者左心室功能可逆性减退，甚至发生心力衰竭相关，并由此引出室性期前收缩诱发性心肌病这一概念。并非所有室性期前收缩最终都会进展为心肌病，这一过程受室性期前收缩负荷、起源部位、QRS波群时程、伴随症状等多因素的共同影响。成功的导管消融术和抗心律失常药物治疗能够有效减少患者室性期前收缩负荷，改善甚至逆转已经受损的心功能。

• Idiopathic premature ventricular contraction is a common type of arrhythmia in clinical practice, and it was previously believed that most of these diseases had a good prognosis. However, in recent years, it has been found that this abnormal heart rhythm, which was generally considered to be benign and did not need much intervention in the past, is related to reversible decline of left ventricular function and even heart failure in some patients, which leads to the concept of premature ventricular contraction induced cardiomyopathy. Not all premature ventricular contraction will eventually progress to cardiomyopathy, and this process is affected by many factors such as premature ventricular contraction burden, origin site, QRS duration, and accompanying symptoms. Successful catheter ablation and antiarrhythmic drug therapy can effectively reduce the burden of premature ventricular contraction and improve or even reverse the damaged cardiac function.