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肺动脉:特发性右室流出道室性心律失常导管消融的关键部位。

Pulmonary artery: A pivotal site for catheter ablation in idiopathic RVOT ventricular arrhythmias.

作者信息

Wang Chunmiao, Zhang Yawen, Hong Fangde, Huang Ying

机构信息

Department of Cardiology, the First Affiliated Hospital of Anhui Medical University, Hefei, China.

出版信息

Pacing Clin Electrophysiol. 2017 Jul;40(7):803-807. doi: 10.1111/pace.13131. Epub 2017 Jun 30.

Abstract

In patients without associated myocardial diseases, characterized by left bundle branch block and inferior axis morphologies, repetitive idiopathic right ventricular tachycardias and ventricular premature contractions typically arise from right ventricular outflow tract (RVOT). Accumulated evidences have shown that radiofrequency catheter ablation is a useful treatment for patients with RVOT ventricular arrhythmias (VAs). Interestingly, several medical centers have shown that pulmonary artery (PA) is a potential novel site for catheter ablation in RVOT-like VAs, particularly in patients where termination of RVOT VAs at the usual site fails. In this review, we comprehensively demonstrated that RVOT VAs were successfully terminated at the site of PA, analyzed the characteristics of surface electrocardiogram and endocardial potentials, and explored the underlying mechanisms for these cases.

摘要

在无相关心肌疾病、以左束支传导阻滞和下轴形态为特征的患者中,反复出现的特发性右室性心动过速和室性早搏通常起源于右室流出道(RVOT)。越来越多的证据表明,射频导管消融术对RVOT室性心律失常(VAs)患者是一种有效的治疗方法。有趣的是,几个医学中心已表明,肺动脉(PA)是类似RVOT的VAs导管消融的一个潜在新部位,特别是在常规部位无法终止RVOT VAs的患者中。在本综述中,我们全面展示了在PA部位成功终止RVOT VAs,分析了体表心电图和心内膜电位特征,并探讨了这些病例的潜在机制。

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