Yoshida Naoki, Yamada Takumi
Division of Cardiovascular Disease, University of Alabama at Birmingham, FOT 930A, 510 20th Street South, 1530 3rd AVE S, Birmingham, AL 35294-0019, USA.
J Arrhythm. 2017 Feb;33(1):66-68. doi: 10.1016/j.joa.2016.04.007. Epub 2016 Jun 1.
A 63-year-old man with a history of remote inferior myocardial infarction and coronary artery bypass grafting (CABG) underwent catheter ablation of ventricular tachycardia (VT). Epicardial catheter ablation of the VT was successful at the crux of the heart despite limited mapping within the pericardial space due to pericardial adhesion. Percutaneous subxiphoidal pericardial approach is usually impossible in patients with a history of open heart surgery due to pericardial adhesions. This report suggested that epicardial VT arising from the crux of the heart could be successfully treated by catheter ablation via subxiphoidal pericardial approach despite pericardial adhesions complicated by prior CABG.
一名有陈旧性下壁心肌梗死和冠状动脉旁路移植术（CABG）病史的63岁男性接受了室性心动过速（VT）导管消融术。尽管由于心包粘连导致心包腔内标测受限，但在心脏十字交叉处进行的心外膜VT导管消融术仍取得成功。由于心包粘连，有心脏直视手术史的患者通常无法采用经皮剑突下心包穿刺入路。本报告表明，尽管既往CABG合并心包粘连，但通过剑突下心包穿刺入路进行导管消融，可成功治疗起源于心脏十字交叉处的心外膜VT。
