Stevenson W G, Nademanee K, Weiss J N, Wiener I
Department of Medicine, University of California, Los Angeles School of Medicine, California.
J Am Coll Cardiol. 1990 Sep;16(3):752-5. doi: 10.1016/0735-1097(90)90370-5.
Endocardial catheter ablation with direct current high voltage shocks was performed in a patient with recurrent syncope due to a catecholamine-sensitive ventricular tachycardia that was drug refractory and occurred in the absence of identifiable heart disease. Pace mapping and catheter activation mapping of the spontaneous and isoproterenol-induced ventricular tachycardia located the tachycardia origin in the right ventricular outflow tract. Ablation dramatically reduced spontaneous ventricular tachycardia and ectopic activity (from 50,000 to less than 100 ectopic beats/24 h). The patient has remained symptom free and without ventricular tachycardia recurrence for 3 years. These observations and review of previous studies suggest that catheter mapping can easily locate the arrhythmia focus in the right ventricular outflow tract and that catheter ablation can be performed at low risk. Catheter ablation is a viable option for the treatment of right ventricular catecholamine-sensitive tachycardias that are unresponsive to antiarrhythmic drugs.
对一名因儿茶酚胺敏感性室性心动过速导致反复晕厥的患者进行了直流高压电击心内膜导管消融术。该室性心动过速对药物难治，且在无明显心脏病的情况下发生。对自发性和异丙肾上腺素诱发的室性心动过速进行起搏标测和导管激动标测，确定心动过速起源于右心室流出道。消融显著减少了自发性室性心动过速和异位活动（从50,000次减少到每24小时少于100次异位搏动）。该患者3年来一直无症状，且无室性心动过速复发。这些观察结果以及对既往研究的回顾表明，导管标测可以轻松定位右心室流出道的心律失常病灶，并且导管消融可以在低风险下进行。对于对抗心律失常药物无反应的右心室儿茶酚胺敏感性心动过速，导管消融是一种可行的治疗选择。
