Strohmer Bernhard, Schernthaner Christiana, Pichler Maximilian
Department of Cardiology, Salzburger Landeskliniken, Paracelsus Private Medical University, Salzburg, Austria.
Pacing Clin Electrophysiol. 2006 Apr;29(4):431-5. doi: 10.1111/j.1540-8159.2006.00367.x.
Focal ablation of trigger premature ventricular complexes (PVCs) from the Purkinje system helped to suppress idiopathic ventricular fibrillation (VF) in an athlete who had suffered from frequent appropriate shock therapies. However, only a few days after successful ablation T-wave oversensing occurred during exercise and resulted in repetitive distressing defibrillator shocks. Despite lack of any changes on the surface ECG, the endocardially recorded electrogram revealed an unfavorable ratio of R-to-T-wave amplitude predisposing to double counting with accelerated heart rates. This case illustrates that T-wave oversensing may complicate the clinical course after successful ablation of malignant Purkinje ectopy.
对一名频繁接受恰当电击治疗的运动员，经导管对浦肯野系统触发室性早搏（PVC）进行局部消融有助于抑制特发性室颤（VF）。然而，成功消融后仅数天，运动期间出现T波感知过度，导致反复令人痛苦的除颤器电击。尽管体表心电图无任何变化，但心内膜记录的电图显示R波与T波振幅之比不利，在心率加快时易导致双重计数。该病例表明，T波感知过度可能使恶性浦肯野异位灶成功消融后的临床病程复杂化。
