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导管消融治疗永久性交界性折返性心动过速及心动过速性心肌病:一例报告

Permanent form of junctional reciprocating tachycardia and tachycardia-induced cardiomyopathy treated by catheter ablation: a case report.

作者信息

Semizel Evren, Ayabakan Canan, Ceviz Naci, Celiker Alpay

机构信息

Department of Pediatric Cardiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.

出版信息

Turk J Pediatr. 2003 Oct-Dec;45(4):338-41.

Abstract

The permanent form of junctional reciprocating tachycardia (PJRT) is usually refractory to drug therapy, and these patients are at risk of developing tachycardia-induced cardiomyopathy. The electrocardiogram insribes inverted P waves in leads 2, 3, aVF as well as left lateral leads, along with a P-R interval shorter than R-P interval during the tachycardia. This report describes a three-year-old male patient with PJRT who underwent successful radiofrequency catheter ablation (RFA) of accessory pathway. On transthoracic echocardiography of patient, decreased ventricular systolic function was observed. RFA was performed by applying radiofrequency pulses. Echocardiograms of the patient, two months after catheter ablation, demonstrated progressive improvement of ventricular function. Transcatheter radiofrequency ablation of accessory pathways in patients with PJRT is an effective, and possibly preferable, form of treatment, especially in cases of tachycardia refractory to multiple pharmacologic treatments or when left ventricular dysfunction is present.

摘要

持续性交界性反复性心动过速(PJRT)通常对药物治疗无效,这些患者有发生心动过速性心肌病的风险。心电图显示在Ⅱ、Ⅲ、aVF导联以及左侧导联出现P波倒置,且心动过速时P-R间期短于R-P间期。本报告描述了一名3岁男性PJRT患者,其成功接受了旁路射频导管消融术(RFA)。对该患者进行经胸超声心动图检查时,观察到心室收缩功能下降。通过施加射频脉冲进行RFA。导管消融术后两个月,该患者的超声心动图显示心室功能逐渐改善。对于PJRT患者,经导管射频消融旁路是一种有效的、可能更可取的治疗方式,尤其是在对多种药物治疗无效的心动过速病例或存在左心室功能障碍的情况下。

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