| H01729 | |
| H番号 | H01729 |
| 名称 | 心室期外収縮 |
| 概要 | Premature ventricular complex (PVC) is characterized by the premature occurrence of a QRS complex that is bizarre in shape and lasts longer than 120 msec. The T wave is large and usually of opposite polarity to the QRS complex. A PVC is usually followed by a full compensatory pause. PVCs are commonly encountered in apparently healthy individuals with a reported incidence of approximately 1% on standard 12-lead electrocardiograms (ECG) and 40% to 75% on routine 24 hour to 48 hour Holter monitoring. The clinical presentation may range from asymptomatic to left ventricular (LV) dysfunction with congestive heart failure. In many patients, ectopic ventricular events manifest as asymptomatic, isolated PVCs that have a benign prognosis in those without structural heart disease. In others, PVCs may be frequent and highly symptomatic, presenting as palpitations, chest discomfort, or presyncope. Clinical evidence suggests that frequent PVCs (variably defined in the literature) are more strongly associated with concomitant cardiac disease. The decision to suppress PVCs is largely based on the presence of symptoms, interference with other therapy (e.g., cardiac resynchronization therapy), or suspicion of PVC-mediated cardiomyopathy. When necessary, treatment for PVCs involves beta-blockers, calcium channel blockers, or other antiarrhythmic drugs and catheter ablation in selected cases. Catheter ablation of frequent PVCs has been demonstrated to be effective at PVC suppression and is associated with improvement or normalization of ventricular function. |
| カテゴリ | 循環器系疾患 |
| ネットワーク | - |
| 病因遺伝子 | - |
| 病原体 | - |
| 環境要因 | - |
| 発癌物質 | - |
| 治療薬 | プロカインアミド塩酸塩 [DR:D00477] キニジン硫酸塩水和物 [DR:D02272] プロプラノロール塩酸塩 [DR:D00483] アテノロール [DR:D00235] ジソピラミド [DR:D00303] フレカイニド酢酸塩 [DR:D00638] ピルシカイニド塩酸塩水和物 [DR:D01554] アセブトロール塩酸塩 [DR:D00597] |
| コメント | - |
| リンク | ICD-11: 7A42 ICD-10: I49.1 I49.2 I49.3 I49.4 MeSH: D018879 |
| 文献 | PMID:25741605 著者 Eugenio PL タイトル Frequent Premature Ventricular Contractions: An Electrical Link to Cardiomyopathy. 雑誌 Cardiol Rev 23:168-72 (2015) DOI:10.1097/CRD.0000000000000063 PMID:25678299 著者 Saurav A, Smer A, Abuzaid A, Bansal O, Abuissa H タイトル Premature ventricular contraction-induced cardiomyopathy. 雑誌 Clin Cardiol 38:251-8 (2015) DOI:10.1002/clc.22371 PMID:23733905 著者 Cantillon DJ タイトル Evaluation and management of premature ventricular complexes. 雑誌 Cleve Clin J Med 80:377-87 (2013) DOI:10.3949/ccjm.80a.12168 PMID:22875587 著者 Adams JC, Srivathsan K, Shen WK タイトル Advances in management of premature ventricular contractions. 雑誌 J Interv Card Electrophysiol 35:137-49 (2012) DOI:10.1007/s10840-012-9698-x PMID:12086238 著者 Hebbar AK, Hueston WJ タイトル Management of common arrhythmias: Part II. Ventricular arrhythmias and arrhythmias in special populations. 雑誌 Am Fam Physician 65:2491-6 (2002) |