Lee H, Chang K C, Lin Y C, Chou H T, Hung J S
Department of Medicine, China Medical College Hospital, Taichung, Taiwan.
J Electrocardiol. 2000 Jan;33(1):79-83. doi: 10.1016/s0022-0736(00)80104-1.
Idiopathic left ventricular tachycardia is characterized by a QRS morphology of right bundle branch block pattern and left axis deviation. Alterations in the QRS configuration and tachycardia cycle length, as well as shifting of the earliest activation site occurred after eliminating the original tachycardia by radiofrequency current in an 18-year-old man with idiopathic left ventricular tachycardia. Activation mapping and entrainment mapping during tachycardia identified 2 putative tachycardia exits, 15 mm apart. Elimination of both tachycardias was accomplished after applying radiofrequency current to each exit separately. We proposed that the first radiofrequency application might have altered the exit site and the zone of slow conduction adjacent to the exit site, such that the ventricular tachycardia had a different QRS morphology and became slower in this patient.
特发性左心室心动过速的特征是QRS形态呈右束支阻滞图形及电轴左偏。在一名患有特发性左心室心动过速的18岁男性患者中，通过射频电流消除原有的心动过速后，QRS形态、心动过速周期长度以及最早激动部位均发生了改变。心动过速期间的激动标测和拖带标测确定了两个假定的心动过速出口，相距15毫米。分别对每个出口施加射频电流后成功消除了两种心动过速。我们推测，首次施加射频电流可能改变了出口部位以及出口部位附近的缓慢传导区，致使该患者的室性心动过速具有不同的QRS形态且变得更慢。
