摘要 6例变异型心绞痛(VA)患者于胸痛发作时经12导联和(或)24 h动态心电图记录到心律失常。其中心绞痛发作时伴发室性早搏二联律3例、短阵室性心动过速1例、Ⅲ度房室阻滞(AVB)2例。1例Ⅲ度AVB者伴有发作性晕厥。冠状动脉造影提示与缺血有关的冠状动脉狭窄3例；余3例冠脉造影结果大致正常，但麦角新碱激发试验均为阳性。2例行药物治疗，3例接受经皮冠状动脉腔内成形术治疗，1例Ⅲ度AVB伴晕厥者置入永久性人工心脏起搏器。结果表明冠状动脉痉挛在VA患者致命性心律失常的发生中具有重要作用。

Abstract Critical arrhythmia was detected by either 12-lead or 24-hour ambulatory electrocardiography during the episode of chest pain in 6 patients with variant angina (VA) including frequent ventricular premature beat in 3 patients,paroxysmal ventricular tachycardia in 1 patient,and third degree atrioventricular block (AVB) in 2 patients.Cardiac syncope history was recorded in a patient with third degree AVB.Significant coronary stenosis related to ischemic zone was uncovered in 3 patients,and coronary spasm induced by ergonovine was demonstrated in other 3 patients.2 patients were recovered following drug therapy,3 patients were performed percutaneous transluminal coronary angioplasty,and 1 patient with AVB companied with syncope induced by coronary spasm was treated with permanent pacemaker implantation.The current report indicats that coronary spasm play an important role in life-threaten arrhythmia in patients with VA.

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