Suzuki Atsushi, Shiga Tsuyoshi, Arai Kotaro, Shoda Morio
Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
BMJ Case Rep. 2013 Dec 10;2013:bcr2013008727. doi: 10.1136/bcr-2013-008727.
Tachycardia-induced cardiomyopathy (TIC) is a reversible form of the left ventricular (LV) systolic dysfunction and is believed to be a relatively acute process. We report a TIC case with a 30-year history of long-lasting persistent atrial tachycardia involving a 44-year-old man previously diagnosed with dilated cardiomyopathy and a low LV ejection fraction (LVEF) of 20%. ECG revealed atrial tachycardia at 110-120 bpm. He was hospitalised with a worsening heart failure. His clinical status was New York Heart Association functional class III, and echocardiography revealed LV dilation and an LVEF of 9%. A two-dimensional speckle-tracking strain measurement revealed LV mechanical dyssynchrony. He underwent radiofrequency ablation for atrial tachycardia. After restoring sinus rhythm, his cardiac symptoms improved immediately. The LV mechanical dyssynchrony decreased a week after ablation, without changes in the LV dilation or LVEF. Thereafter, the LV dilation and systolic function gradually improved, and atrial tachycardia and heart failure remained absent.
心动过速性心肌病（TIC）是左心室（LV）收缩功能障碍的一种可逆形式，被认为是一个相对急性的过程。我们报告一例有30年持续性房性心动过速病史的TIC病例，患者为一名44岁男性，此前被诊断为扩张型心肌病，左心室射血分数（LVEF）低至20%。心电图显示房性心动过速，心率为110 - 120次/分钟。他因心力衰竭加重入院。其临床状态为纽约心脏协会心功能Ⅲ级，超声心动图显示左心室扩张，LVEF为9%。二维斑点追踪应变测量显示左心室机械不同步。他接受了房性心动过速的射频消融治疗。恢复窦性心律后，他的心脏症状立即改善。消融术后一周，左心室机械不同步减轻，左心室扩张或LVEF无变化。此后，左心室扩张和收缩功能逐渐改善，房性心动过速和心力衰竭未再出现。
