Walczak F, Biederman A, Lukasik-Madej B, Stepińska J, Bieganowska K, Turska-Kmieć A, Jedynak Z, Sliwiński M, Hoffman M, Kubicka K
I Kliniki Wad Serca, Warszawa.
Kardiol Pol. 1991;35(9):181-3.
Recurrent automatic atrial tachycardia can induce dilated cardiomyopathy. We present clinical and therapeutic problems of 16 years old male with ectopic left atrial tachycardia refractory to pharmacological therapy. In this patient long periods of atrial tachycardia 200-240/min due to lack of effective medication caused cardiac failure. Uncontrolled taking of various antiarrhythmic drugs and persistent tachycardia led to cardiogenic shock. The electrophysiologic study revealed focus of the tachycardia localized in the area of left cardiac auricle. The rate of the tachycardia was changing from 84 to 240/min, with periods of Mobitz I block in the AV node. In periods of 1:1 AV conduction the tachycardia had sometimes LBBB QRS morphology. The atrial tachycardia provoked unsustained ventricular one. The patient was operated. Resection of left auricle and mitral valvuloplasty were performed. After the operation the patient regained undisturbed sinus rhythm and symptoms of heart failure disappeared.
反复自动性房性心动过速可诱发扩张型心肌病。我们介绍了一名16岁男性患者，患有异位性左房性心动过速，药物治疗无效，面临的临床和治疗问题。在该患者中，由于缺乏有效药物，长时间的房性心动过速（200-240次/分钟）导致了心力衰竭。无节制地服用各种抗心律失常药物以及持续性心动过速导致心源性休克。电生理研究显示心动过速的起源位于左心耳区域。心动过速的速率从84次/分钟变化到240次/分钟，房室结存在文氏I型阻滞期。在1:1房室传导期间，心动过速有时呈现左束支传导阻滞的QRS形态。房性心动过速诱发了非持续性室性心动过速。该患者接受了手术。进行了左心耳切除术和二尖瓣成形术。术后患者恢复了正常窦性心律，心力衰竭症状消失。
