Kukla Piotr, Biernacka Katarzyna E, Jastrzębski Marek, Bryniarski Leszek
Oddział Internistyczno-Kardiologiczny, Szpital Specjalistyczny, Gorlice.
Kardiol Pol. 2011;69(2):177-9; discussion 180.
We described a case of 33 year-old woman with catecholaminergic polymorphic ventricular tachycardia (VT) with first presentation as syncope in age of 14. In subsequent ECGs premature ventricular contractions (PVC) with morphology of left bundle branch block-like pattern with positive R wave in leads: II, III and aVF what suggested PVC arising from right ventricular outflow tract were observed. Nonsustained VT was observed. No ventricular arrhythmias were induced during EPS. The 2 unsuccessful sessions of ablation were performed in the right ventricular outflow area. The exercise test provoked bidirectional VT. The adrenaline infusion provoked bidirectional nonsustained VT and the U wave amplitude augmentation. Betablocker was initiated (bisoprolol). The patient is free of symptoms, only single PVC is observed.
我们描述了一名33岁女性,患有儿茶酚胺能多形性室性心动过速(VT),首次表现为14岁时晕厥。在随后的心电图中,观察到室性早搏(PVC),其形态呈左束支阻滞样图形,在Ⅱ、Ⅲ和aVF导联有正向R波,提示PVC起源于右心室流出道。观察到非持续性VT。电生理检查(EPS)期间未诱发室性心律失常。在右心室流出区域进行了2次消融手术均未成功。运动试验诱发了双向VT。肾上腺素输注诱发了双向非持续性VT以及U波振幅增大。开始使用β受体阻滞剂(比索洛尔)。患者无症状,仅观察到单个PVC。