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导管消融术中奇亚里网在右心房意外夹闭电标测导管

Accidental Entrapment of Electrical Mapping Catheter by Chiari's Network in Right Atrium during Catheter Ablation Procedure.

作者信息

Sakamoto Atsushi, Urushida Tsuyoshi, Sakakibara Tomoaki, Sano Makoto, Suwa Kenichiro, Saitoh Takeji, Saotome Masao, Katoh Hideki, Satoh Hiroshi, Hayashi Hideharu

机构信息

Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan.

出版信息

Case Rep Cardiol. 2016;2016:1302473. doi: 10.1155/2016/1302473. Epub 2016 Jun 5.

Abstract

A 78-year-old male was admitted to our hospital due to frequent palpitation. His electrocardiogram (ECG) presented regular narrow QRS tachycardia with 170 bpm, and catheter ablation was planned. During electroanatomical mapping of the right atrium (RA) with a multiloop mapping catheter, the catheter head was entrapped nearby the ostium of inferior vena cava. Rotation and traction of the catheter failed to detach the catheter head from the RA wall. Exfoliation of connective tissue twined around catheter tip by forceps, which were designed for endomyocardial biopsy, succeeded to retract and remove the catheter. Postprocedural echocardiography and pathologic examination proved the existence of Chiari's network. The handling of complex catheters in the RA has a potential risk of entrapment with Chiari's network.

摘要

一名78岁男性因频繁心悸入院。他的心电图(ECG)显示规则的窄QRS心动过速,心率为170次/分钟,计划进行导管消融。在使用多环标测导管对右心房(RA)进行电解剖标测时,导管头被困在下腔静脉口附近。导管的旋转和牵引未能使导管头与RA壁分离。使用专为心内膜活检设计的镊子强行剥脱缠绕在导管尖端的结缔组织,成功收回并移除了导管。术后超声心动图和病理检查证实存在奇阿里网。在RA中操作复杂导管存在被奇阿里网困住的潜在风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdf9/4912992/c79197f03e5a/CRIC2016-1302473.001.jpg

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