Meyer C, Martinek M, Winter S, Nesser H-J, Pürerfellner H
Abteilung für Innere Medizin II/Kardiologie, Krankenhaus der Elisabethinen, Linz, Osterreich.
Herzschrittmacherther Elektrophysiol. 2010 Sep;21(3):189-95. doi: 10.1007/s00399-010-0103-0.
The population of adults with surgically corrected tetralogy of Fallot (TOF) is increasing. Atrial and ventricular arrhythmias are prevalent, and therapeutical approaches including implantable cardioverter-defibrillators and radiofrequency catheter ablation need to be considered carefully for the prevention of hemodynamic deterioration and sudden cardiac death. Complex anatomy, myocardial hypertrophy, and broad channels of slow conduction may in part explain some challenges regarding risk stratification, and identification/modification of the arrhythmogenic substrate in these patients. The aim of this brief review is 2-fold: (1.) To present insights into characteristics of typical TOF related arrhythmias and (2.) to reflect therapeutical concepts targeting tachyarrhythmias in these patients by focusing on catheter ablation.
接受过法洛四联症(TOF)手术矫正的成年人口正在增加。心房和心室心律失常很常见,需要仔细考虑包括植入式心脏复律除颤器和射频导管消融在内的治疗方法,以预防血流动力学恶化和心源性猝死。复杂的解剖结构、心肌肥厚以及缓慢传导的广泛通道可能部分解释了这些患者在风险分层以及识别/改变致心律失常基质方面面临的一些挑战。本简要综述的目的有两个:(1)深入了解典型TOF相关心律失常的特征;(2)通过聚焦导管消融来反映针对这些患者室上性心动过速的治疗理念。