导管消融治疗室性早搏诱发的心肌病。
Catheter ablation of premature ventricular contraction-induced cardiomyopathy.
作者信息
Ezzat Vivienne A, Liew Reginald, Ward David E
机构信息
Cardiology Department, Princess Alexandra Hospital, Hamstel Road, Harlow CM20 1QX, UK.
出版信息
Nat Clin Pract Cardiovasc Med. 2008 May;5(5):289-93. doi: 10.1038/ncpcardio1180. Epub 2008 Mar 25.
BACKGROUND
A 44-year-old female presented with a long history of chest pain, palpitations and increasing dyspnea. Electrocardiography and 24 h Holter monitoring revealed multiple premature ventricular complexes (PVCs), and echocardiography demonstrated significant left ventricular dilatation and systolic impairment. After further investigation it was concluded that this cardiomyopathy was secondary to the observed multiple PVCs and that these represented a potential target for treatment.
INVESTIGATIONS
Electrocardiography, echocardiography, cardiac MRI, 24 h Holter monitoring, coronary angiography, tilt testing and invasive electrophysiological testing using a multielectrode array catheter.
DIAGNOSIS
PVC-induced dilated cardiomyopathy.
MANAGEMENT
Electrophysiological mapping and cryoablation of the focus of the ventricular ectopy.
背景
一名44岁女性，有长期胸痛、心悸及进行性加重的呼吸困难病史。心电图及24小时动态心电图监测显示多个室性早搏（PVC），超声心动图显示左心室明显扩张及收缩功能受损。进一步检查后得出结论，该心肌病继发于观察到的多个室性早搏，且这些室性早搏是潜在的治疗靶点。
检查
心电图、超声心动图、心脏磁共振成像、24小时动态心电图监测、冠状动脉造影、倾斜试验以及使用多电极阵列导管进行的有创电生理检查。
诊断
室性早搏诱发的扩张型心肌病。
治疗
对室性异位灶进行电生理标测及冷冻消融。
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