Emmel Mathias, Sreeram Nayaranswami, Khalil Markus, Adelmann Roland, Brockmeier Konrad
Pediatric Cardiology, Heart Center, University Hospital of Cologne, Koeln, Cologne, Germany.
J Electrocardiol. 2011 Nov-Dec;44(6):802-5. doi: 10.1016/j.jelectrocard.2011.02.003. Epub 2011 Mar 30.
The verapamil-sensitive Belhassen tachycardia is a ventricular reentrant tachycardia, involving left-sided Purkinje fibers and abnormal Purkinje or myocardial tissue. Ablation is feasible, targeting a diastolic fascicular potential in the apical left ventricle.
We report on a 13-year-old girl with left posterior fascicular ventricular tachycardia. Tachycardia stopped during ablation, targeting a left-sided distal fascicular potential, and afterward, there was no tachycardia inducible, but it reoccurred 2 weeks later. During a second procedure, we transected the left posterior fascicle by a line, also with early success. After a further recurrence, we ablated a longer proximal segment of the left posterior fascicle including its most proximal electrograms. After this ablation, there was no further recurrence.
In refractory patients, proximal ablation of the posterior fascicle might be indicated.
维拉帕米敏感的贝尔哈森心动过速是一种室性折返性心动过速，涉及左侧浦肯野纤维以及异常的浦肯野或心肌组织。消融是可行的，靶点为左心室心尖部的舒张期束支电位。
我们报告一名13岁患有左后分支室性心动过速的女孩。在针对左侧远端束支电位进行消融时，心动过速终止，之后未诱发出心动过速，但2周后复发。在第二次手术中，我们通过一条线横断左后分支，同样早期成功。在进一步复发后，我们消融了左后分支更长的近端节段，包括其最近端的电图。此次消融后未再复发。
对于难治性患者，可能需要对后分支进行近端消融。
