Mizobuchi Masahiro, Enjoji Yoshihisa, Shibata Kensaku, Funatsu Atsushi, Yokouchi Itaru, Kanbayashi Daisuke, Kobayashi Tomoko, Nakamura Shigeru
Cardiovascular center, Kyoto Katsura Hospital, Kyoto, Japan.
J Interv Card Electrophysiol. 2006 Jan;15(1):43-7. doi: 10.1007/s10840-006-6720-1.
A case with two different types of atrial reentrant tachycardia of superior vena cava (SVC) origin is presented. Recent clinical studies have shown that the origin of focal atrial tachycardia typically lies in the venous structures connecting to both atria--the coronary sinus, the superior and inferior vena cava, and the pulmonary vein. These foci have atrial muscle fiber extensions which have electrophysiological characteristics essential to generation of focal ectopic firing. However, little is known about reentrant mechanism of these venous structures. In this report, we present a case of two atrial tachycardias (SVT1 and SVT2) independently originating from the SVC. SVT1 had 430 ms of tachycardia cycle length, and SVT2 had 390 ms of tachycardia cycle length. Both of them showed the character of reentry, and their earliest activations were recorded in the SVC. They were successfully eliminated by focal radiofrequency ablation in the SVC.
本文报道了一例起源于上腔静脉（SVC）的两种不同类型房性折返性心动过速的病例。近期临床研究表明，局灶性房性心动过速的起源通常位于连接两个心房的静脉结构——冠状窦、上腔静脉和下腔静脉以及肺静脉。这些病灶有心房肌纤维延伸，具有产生局灶性异位搏动所必需的电生理特征。然而，关于这些静脉结构的折返机制知之甚少。在本报告中，我们展示了一例独立起源于SVC的两种房性心动过速（SVT1和SVT2）的病例。SVT1的心动过速周期长度为430毫秒，SVT2的心动过速周期长度为390毫秒。两者均表现出折返特征，且最早激动记录于SVC。通过在SVC进行局灶性射频消融，成功消除了这两种心动过速。
