Mizukami Akira, Suzuki Makoto, Nakamura Rena, Kuroda Shunsuke, Ono Maki, Matsue Yuya, Iwatsuka Ryota, Yonetsu Taishi, Matsumura Akihiko, Hashimoto Yuji
Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
Department of Cardiology, Yokohama Minami Kyousai Hospital, 1-21-1 Mutsuurahigashi, Kanazawa-ku, Yokohama, Kanagawa 236-0037, Japan.
J Arrhythm. 2016 Jun;32(3):227-9. doi: 10.1016/j.joa.2016.01.001. Epub 2016 Feb 3.
A 26-year-old woman in her first pregnancy presented with persistent atrial tachycardia (AT). AT was resistant to medications, cardioversions, and the first attempt of catheter ablation. Two months after delivery she developed severe systolic dysfunction and circulatory collapse. Emergent catheter ablation was performed with the support of percutaneous cardiopulmonary bypass and intraaortic balloon pump. The AT originated in the apex of the right atrial appendage (RAA). Repeated attempts at ablation were unsuccessful, prompting surgical RAA resection, which terminated the tachycardia and improved the cardiac function. Histological examination of resected RAA provided insights into mechanism of resistance to catheter ablation.
一名26岁初孕女性出现持续性房性心动过速（AT）。AT对药物、心脏复律及首次导管消融尝试均耐药。分娩后两个月，她出现严重的收缩功能障碍和循环衰竭。在经皮心肺旁路和主动脉内球囊泵的支持下进行了紧急导管消融。AT起源于右心耳（RAA）尖部。多次消融尝试均未成功，促使进行手术切除RAA，从而终止了心动过速并改善了心功能。对切除的RAA进行组织学检查为导管消融耐药机制提供了见解。
