Jastrzebski Marek, Bacior Bogumiła, Pitak Maciej, Załuska-Pitak Beata, Rudziński Andrzej, Czarnecka Danuta
I Klinika Kardiologii i Nadciśnienia Tetniczego, Szpital Uniwersytecki, ul. Kopernika 17, 31-501 Kraków, Poland.
Kardiol Pol. 2009 Dec;67(12):1412-6.
We present a case of 14-year-old boy with incessant atrial tachycardia from right atrial appendage, resistant to pharmacotherapy and with early signs of the left ventricle tachyarrhythmic dysfunction. The P-wave was positive in leads I, II, III, aVF, negative in aVR, aVL. Moreover, P waves configuration specific for this localization: negative in V1-V2 that become positive in V3-V6 was present. After first ablation session a recurrence was observed after 3 weeks, due to inadequate power delivery resulting from trabeculation/anatomy that limited conventional ablation catheter cooling. Second ablation session with the use of an active electrode cooling and 3D mapping system was successful.
我们报告一例14岁男孩，患有源于右心耳的持续性房性心动过速，药物治疗无效，且有左心室快速心律失常功能障碍的早期迹象。I、II、III、aVF导联P波直立，aVR、aVL导联P波倒置。此外，存在该定位特有的P波形态：V1-V2导联P波倒置，V3-V6导联P波直立。首次消融术后3周出现复发，原因是小梁结构/解剖结构导致传统消融导管冷却受限，能量传递不足。使用主动电极冷却和三维标测系统进行的第二次消融手术取得成功。
