心动过速性致右室心肌病：经心外膜射频消融治疗一种罕见且意想不到的室性心动过速

Tachycardia-induced right ventricular cardiomyopathy: epicardial radiofrequency ablation of an unusual and unexpected ventricular tachycardia.

作者信息

Massoure Pierre-Laurent, Jais Pierre, Sacher Frederic, Haissaguerre Michel

机构信息

Hôpital Cardiologique du Haut Lévêque, Pessac, Bordeaux, France.

出版信息

J Cardiovasc Electrophysiol. 2009 Jul;20(7):813-7. doi: 10.1111/j.1540-8167.2008.01402.x. Epub 2009 Jan 16.

DOI:10.1111/j.1540-8167.2008.01402.x

PMID:19207776

Abstract

A 38-year-old man without prior medical history was hospitalized for sustained monomorphic ventricular tachycardia (VT) left bundle branch block pattern with inferior QRS axis resistant to beta blockers. Right ventricular (RV) ejection fraction (EF) was 28%. Left ventricular EF was normal. Right and left endocardial ablation failed. Percutaneous epicardial radiofrequency application at the lateral mitral annulus was successful. The RVEF later normalized. Some VTs originating from the left ventricular epicardium are potential mimickers of benign VTs originating from the ventricular outflow tract (right or left) or arrhythmogenic right ventricular cardiomyopathy VT and they may induce isolated RV dysfunction.

摘要

一名38岁无既往病史的男性因持续性单形性室性心动过速（VT）伴左束支传导阻滞图形、下QRS电轴，且对β受体阻滞剂耐药而住院。右心室（RV）射血分数（EF）为28%。左心室EF正常。右心内膜和左心内膜消融均失败。在二尖瓣环外侧进行经皮心外膜射频消融成功。之后右心室射血分数恢复正常。一些起源于左心室心外膜的室性心动过速可能会模仿起源于（右或左）心室流出道的良性室性心动过速或致心律失常性右心室心肌病室性心动过速，并且可能导致孤立的右心室功能障碍。