Atik Fernando A, Garcia Maria Fernanda M, Baggio Jose Mario, Faber Cristiano N, Corso Ricardo B, Caneo Luiz Fernando, Sarabanda Alvaro V
Department of Cardiovascular Surgery, Heart Institute of Federal District, Zerbini Foundation, Brasilia, Brazil.
Ann Thorac Surg. 2009 Feb;87(2):631-3. doi: 10.1016/j.athoracsur.2008.06.065.
A 63-year-old diabetic woman was emergently submitted to coronary artery bypass grafting in the setting of acute myocardial infarction. Recurrent, drug-refractory episodes of ventricular arrhythmia occurred for 2 weeks postoperatively, despite no documentation of ongoing myocardial ischemia and optimum medical treatment. Ventricular arrhythmia was initiated by premature ventricular contractions originating from the Purkinje system within the infarct border zone. Radiofrequency catheter ablation was performed at sites where Purkinje potentials were recorded, leading to arrhythmia cessation. A week later, an implantable cardioverter defibrillator was inserted and she was discharged home a few days later. At 15-month follow-up, there were no further episodes of arrhythmia and ventricular function had improved.
一名63岁的糖尿病女性在急性心肌梗死的情况下紧急接受了冠状动脉搭桥手术。术后2周内，尽管没有持续心肌缺血的记录且接受了最佳药物治疗，但仍反复出现药物难治性室性心律失常。室性心律失常由梗死边缘区内浦肯野系统起源的室性早搏引发。在记录到浦肯野电位的部位进行了射频导管消融，心律失常停止。一周后，植入了植入式心律转复除颤器，几天后她出院回家。在15个月的随访中，没有再出现心律失常发作，心室功能有所改善。
