Aizawa Y, Funazaki T, Takahashi M, Naitoh N, Miyajima T, Kusano Y, Shibata A, Misaki T
First Department of Internal Medicine, Niigata University School of Medicine, Japan.
Pacing Clin Electrophysiol. 1991 Nov;14(11 Pt 1):1606-13. doi: 10.1111/j.1540-8159.1991.tb02736.x.
In two patients with arrhythmogenic right ventricular dysplasia (ARVD), sustained ventricular tachycardia (VT) was induced by programmed stimulations during serial drug testings. One patient had five and the other had two VT morphologies, and the sites of origin were determined by endocardial catheter mappings. When overdrive pacing was performed, constant fusion in the QRS complex was observed in the two patients. Constant fusion of a different degree was also observed at different paced cycle lengths. Both patients had dilated right ventricles and wall-motion abnormality, and the diagnosis of ARVD was further confirmed by the specimen resected at the site of origin of VT. Therefore, VT in ARVD can be entrained and reentry is the most likely mechanism of such VT.
在两名致心律失常性右心室发育不良(ARVD)患者中,在系列药物测试期间通过程序刺激诱发了持续性室性心动过速(VT)。一名患者有五种,另一名患者有两种VT形态,起源部位通过心内膜导管标测确定。进行超速起搏时,两名患者均观察到QRS波群的恒定融合。在不同的起搏周期长度下也观察到不同程度的恒定融合。两名患者均有右心室扩张和室壁运动异常,VT起源部位切除的标本进一步证实了ARVD的诊断。因此,ARVD中的VT可被拖带,折返是此类VT最可能的机制。