Yamada Takumi, Doppalapudi Harish, McElderry H Thomas, Kay G Neal
Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama 35294–0019, USA.
Pacing Clin Electrophysiol. 2012 May;35(5):e112-5. doi: 10.1111/j.1540-8159.2010.02981.x. Epub 2010 Nov 22.
A 39-year-old man with idiopathic monomorphic premature ventricular contractions (PVCs), exhibiting a right bundle branch block and inferior axis QRS morphology, underwent electrophysiological testing. After a radiofrequency (RF) application to the anterior mitral annulus (MA) eliminated the spontaneous PVC morphology, a second PVC morphology occurred. Pacing from the first ablation site exhibited an excellent match to the second PVCs with a long stimulus to QRS interval. An RF application delivered near the first lesion eliminated all PVCs. The MA PVCs in this case exhibited a single origin with multiple breakouts and preferential conduction that were unmasked by RF ablation.
一名39岁患有特发性单形性室性早搏（PVC）的男性，呈现右束支传导阻滞和下轴QRS形态，接受了电生理检查。在对二尖瓣前环（MA）进行射频（RF）消融消除了自发PVC形态后，出现了第二种PVC形态。从第一个消融部位起搏与第二种PVC表现出极佳匹配，刺激到QRS间期较长。在第一个损伤部位附近进行RF消融消除了所有PVC。该病例中的MA PVC表现为单一起源、多个突破点和优先传导，这些通过RF消融得以揭示。
