Tokuda Michifumi, Yamane Teiichi, Matsuo Seiichiro, Ito Keiichi, Narui Ryohsuke, Hioki Mika, Tanigawa Shin-Ichi, Nakane Tokiko, Yamashita Seigo, Inada Keiichi, Shibayama Kenri, Miyanaga Satoru, Yoshida Hiroshi, Miyazaki Hidekazu, Date Taro, Sugimoto Ken-Ichi, Yoshimura Michihiro
Department of Cardiology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Heart Vessels. 2011 Nov;26(6):667-71. doi: 10.1007/s00380-010-0113-1. Epub 2011 Jan 28.
Pulmonary vein (PV) isolation was performed in atrial fibrillation (AF) patients whose cardiac rhythm was dominated by the ectopic beats originating from the PV. We herein report two cases with dominant PV ectopic rhythm that underwent catheter ablation for the treatment of paroxysmal AF. In one case, a permanent pacemaker implantation was required to treat a symptomatic long sinus pause after the isolation of all four PVs, while no AF was documented during the 5-year period after ablation. However, the isolation of all four PVs except for a PV with a dominant ectopic rhythm was performed in the other case. The latter case was free from both AF and symptomatic bradycardia following the procedure without the implantation of a pacemaker. Selective PV isolation therefore appears to be an effective therapy to both achieve the successful treatment of AF and to prevent the manifestation of sick sinus syndrome.
在以源自肺静脉（PV）的异位搏动为主导心律的心房颤动（AF）患者中进行肺静脉隔离。我们在此报告两例以PV为主导的异位心律患者，他们接受了导管消融术以治疗阵发性AF。在一例中，在隔离所有四条PV后，需要植入永久性起搏器来治疗有症状的长窦房停搏，而在消融后的5年期间未记录到AF。然而，在另一例中，除了具有主导异位心律的PV外，对所有四条PV进行了隔离。后一例患者在手术后既没有AF也没有症状性心动过缓，无需植入起搏器。因此，选择性PV隔离似乎是一种既能成功治疗AF又能预防病态窦房结综合征表现的有效疗法。
