de Paola A A, Gomes J A, Miyamoto M H, Fo E E
Division of Clinical Cardiac Electrophysiology, Hospital Sao Paulo, Escola Paulista de Medicina, Brazil.
J Am Coll Cardiol. 1992 Aug;20(2):480-2. doi: 10.1016/0735-1097(92)90121-3.
A case of incessant ventricular tachycardia in a patient with Chagas' disease that was successfully terminated by chemical ablation is reported.
Chagas' disease is a common medical problem in South America. Ventricular tachyarrhythmias, atrioventricular conduction disturbances, congestive heart failure and sudden cardiac death are important manifestations of this disease.
Selective catheterization of the coronary artery supplying the arrhythmogenic area was performed by using a conventional angioplasty system and the arrhythmogenic area was ablated by injection of 96% sterile ethanol.
Ethanol (96%) injection initially in a lateral branch of the left circumflex artery and 2 days later in the proximal segment of the artery resulted in termination of ventricular tachycardia. Two weeks after ablation, programmed ventricular stimulation failed to induce ventricular tachycardia.
Transcoronary chemical ablation should be considered in selected cases of Chagas' disease with incessant ventricular tachycardia.
报告1例恰加斯病患者持续性室性心动过速经化学消融成功终止的病例。
恰加斯病是南美洲常见的医学问题。室性快速心律失常、房室传导障碍、充血性心力衰竭和心源性猝死是该病的重要表现。
使用传统血管成形术系统对供应致心律失常区域的冠状动脉进行选择性插管，并通过注射96%无菌乙醇对致心律失常区域进行消融。
最初在左旋支动脉的一个侧支注射乙醇（96%），2天后在动脉近端注射，导致室性心动过速终止。消融后两周，程序心室刺激未能诱发室性心动过速。
对于选定的恰加斯病合并持续性室性心动过速病例，应考虑经冠状动脉化学消融。
