儿茶酚胺敏感性室性心动过速（CPVT）是一种高危的遗传性心脏离子通道疾病。近年来，CPVT合并房性心律失常成为研究热点，但以房性心动过速（房速）起病的CPVT鲜有报道。本文报道1例患儿在反复晕厥后2年余才监测到室性早搏（室早）、室性心动过速（室速），以及其后几乎每次复查均可见，在此之前监测到的心律失常始终为房速，未发现室早、室速，明确诊断为以房速起病的儿童CPVT，选择β受体阻滞剂联合普罗帕酮针对性治疗，随访发现可同时有效抑制室早、室速及房速，无晕厥发作。

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a high-risk inherited cardiac channelopathy. In recent years,CPVT complicated by atrial arrhythmias has become a research hotspot. However, CPVT presenting with atrial tachycardia (AT) as the initial manifestation is rarely reported. This article reports a case of a pediatric patient in whom premature ventricular complexes (PVC) and ventricular tachycardia (VT) were only detected more than two years after recurrent syncope, and these ventricular arrhythmias were detected in almost all subsequent re-examinations. Prior to that, only AT was detected on monitoring, without any PVC or VT. A definitive diagnosis of CPVT with AT as the initial manifestation in a child was established. The combination therapy of beta-blockers and propafenone to CPVT was administered. During follow-up, this regimen effectively suppressed PVC, VT and AT simultaneously, and no further syncopal episodes occurred.