懷孕中心臟心室頻脈（ventricular tachycardia）是罕見的。由右心室出口產生心室頻 脈（right ventricular outflow tract ventricular tachycardia）的機制至今尚未明瞭。一些藥物 adenosine、lidocaine、sotalol、propranolol、metoprolol、digoxin及 quinidine被證實可以安全 的選擇用來治療懷孕婦女的心律不整。對於懷孕中產生心室頻脈，如果血液動力學是穩定而 且必需治療時，可以選擇乙型阻斷劑（β-blockers）；如果心室頻脈使得血行動力學變得不 穩定或是如果造成胎兒的危險時，應該立刻執行心臟電擊。我們報告一位懷孕婦女有由右心 室出口產生心室頻脈，對於 propranolol的治療無反應，當時血壓已呈現不穩定現象，胎心音 也逐漸下降，在使用心臟電擊後，立即引產。最後這名患者的心室頻脈在生產後成功受到控 制。出院後追蹤心臟超音波並未發現有結構性心臟問題。

Maternal cardiac ventricular tachycardia (VT) is rare. The mechanism of right ventricular outflow tract (RVOT) VT in pregnancy remains unknown. Antiarrhythmic agents, such as propranolol, metoprolol, digoxin, and quinidine, have been extensively tested during pregnancy and have been proven safe. For the ventricular tachycardia in pregnancy, if hemodynamics is stable and therapy is necessary, β-blockers are the drug of choice. If at any time VT becomes unstable or if there is evidence of fetal distress, cardioversion should be performed immediately. Here, we report a case of a patient with RVOT VT in pregnancy at 30 weeks' gestation and refractory to propranolol. When the patient suffered VT, unstable blood pressure and fetal distress were noted. We performed cardioversion immediately and induced labor as soon as possible. This patient's VT was successfully controlled by verapamil after the delivery. There was no any structure heart disease revealed by the echocardiogram. ( J lntern Med Taiwan 2010; 21: 140-143 )