Malcić Ivan, Buljević Bruno, Kaltenbrunner Wilhelm, Jelasić Drazen, Mustapić Zeljka
Klinika za pedijatriju, Medicinski fakultet i KBC Zagreb.
Lijec Vjesn. 2007 Mar-Apr;129(3-4):66-9.
We present 14-year-old girl with permanent junctional reciprocating tachycardia which was refractory to medicamentous therapy, who also had dilated cardiomyopathy. She underwent successful radiofrequent catheter ablation of accessory pathway after wich the histologic changes in the myocardium were observed in the form of compensatory hypertrophy of cardiac muscle (cardiac remodelling). The question of cause and consequence appeared: whether the arrhythmia is a consequence of dilated cardiomyopathy, or it is tachycardia- induced cardiomyopathy. This particular issue is discussed in this article. Based on the diagnostic procedure and complete recovery of myocardium after catheter ablation of accessory pathway, it is obvious that the tachycardia was due to tachicardiomyopathy, i.e. cardiomyopathy caused by permanent reciprocating junctional tachycardia.
我们报告一名14岁患有永久性交界性反复性心动过速且药物治疗无效的女孩,她同时还患有扩张型心肌病。她接受了成功的射频导管消融旁路治疗,之后观察到心肌的组织学变化表现为心肌代偿性肥大(心脏重塑)。于是出现了因果关系的问题:心律失常是扩张型心肌病的结果,还是心动过速诱发的心肌病。本文将讨论这一特殊问题。基于诊断过程以及在导管消融旁路后心肌的完全恢复,很明显心动过速是由心动过速性心肌病引起的,即由永久性交界性反复性心动过速导致的心肌病。