Greene C A, Case C L, Gillette P C
Medical University of South Carolina, South Carolina Children's Heart Center, Charleston.
Pacing Clin Electrophysiol. 1991 Nov;14(11 Pt 1):1593-7. doi: 10.1111/j.1540-8159.1991.tb02734.x.
Incessant supraventricular tachycardia (SVT) resistant to pharmacological agents may cause cardiac dysfunction requiring more aggressive therapy. We present the case of a 12-year-old postoperative Mustard patient who developed biventricular heart failure due to an atrial ectopic tachycardia resistant to amiodarone. Using endocavitary direct current fulguration techniques, catheter ablation of the His bundle was successfully performed after unsuccessful attempts at ablation of the ectopic atrial foci. After placement of a permanent transvenous rate responsive ventricular pacemaker, the patient's clinical status and cardiac function improved. Endocavitary fulguration of the His bundle is technically feasible after the Mustard procedure and should be considered for treatment of selective cases of pharmacologically resistant SVT.
对药物治疗无效的持续性室上性心动过速（SVT）可能导致心脏功能障碍，需要更积极的治疗。我们报告一例12岁的Mustard术后患者，因对胺碘酮耐药的房性异位性心动过速而出现双心室心力衰竭。在对异位心房灶进行消融尝试失败后，采用心腔内直流电电灼技术成功进行了希氏束导管消融。植入永久性经静脉频率应答式心室起搏器后，患者的临床状况和心脏功能得到改善。Mustard手术后，心腔内电灼希氏束在技术上是可行的，对于药物抵抗性SVT的选择性病例应考虑采用该方法进行治疗。
