Ventricular Arrhythmias in Apparently Normal Hearts

摘要

The diagnosis of ventricular arrhythmia in patients with structurally normal hearts is often accompanied by a sense of trepidation among patients as well as treating physicians. Unlike patients with a history of myocardial infarction or nonischemic cardiomyopathy, where the treatment strategy tends to be more obvious, patients with structurally normal hearts and ventricular arrhythmias tend to be underrepresented in large clinical trials. Many have a benign prognosis, but this is not uniformly true. Epidemiologic studies have shown frequent premature ventricular complexes (PVCs) to be associated with a worse prognosis. Malignant variants of PVCs may induce ventricular fibrillation even in an apparently normal heart, a term often used to indicate preserved left ventricular function. Rigorous exclusion of structural heart disease has not been performed in many of these studies.