Kofune Masayoshi, Watanabe Ichiro, Okumura Yasuo, Ashino Sonoko, Ohkubo Kimie, Nakai Toshiko, Hirayama Atsushi
Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
J Electrocardiol. 2011 Jan-Feb;44(1):87-91. doi: 10.1016/j.jelectrocard.2010.04.003. Epub 2010 May 7.
A 59-year-old man with premature ventricular contractions (PVCs) and slow ventricular tachycardia (VT) underwent electrophysiologic testing. The left ventricular ejection fraction was 27%. Activation mapping showed the site of earliest activation to be the posterolateral site of the right ventricle inflow tract, and we considered this to be the focal mechanism underlying the PVCs/slow VT. Radiofrequency current delivered at this site induced a cluster of rapid ventricular beats (sustained VT) with the same QRS morphology as the PVCs, followed by ventricular fibrillation. The PVC/VT focus might have served as an abnormal automatic trigger and driver for the ventricular fibrillation.
一名患有室性早搏（PVC）和缓慢型室性心动过速（VT）的59岁男性接受了电生理检查。左心室射血分数为27%。激动标测显示最早激动部位为右心室流入道的后外侧部位，我们认为这是PVC/缓慢型VT的局灶机制。在此部位施加射频电流诱发了一组与PVC具有相同QRS形态的快速室性搏动（持续性VT），随后发生心室颤动。PVC/VT病灶可能作为心室颤动的异常自动触发因素和驱动因素。
