Zauner Florian, Sieweke Jan-Thorben, Hohmann Stephan, Duncker David, Riehle Christian, Napp L Christian, Flierl Ulrike, König Thorben, Veltmann Christian
Department of Cardiology & Angiology, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625, Hannover, Germany.
BMC Cardiovasc Disord. 2017 Sep 12;17(1):244. doi: 10.1186/s12872-017-0679-y.
Wolff-Parkinson-White (WPW) syndrome and idiopathic left ventricular tachycardia (ILVT) are rare and up to now the coexistence of both entities has rarely been reported. In patients with ventricular preexcitation the underlying mechanism of paroxysmal tachycardia most likely is atrioventricular reentrant tachycardia (AVRT). However, without ECG documentation of the tachycardia diagnosis of the underlying mechanism cannot be made due to similar clinical presentation of AVRT and ILVT.
We report a case of a two-staged occurrence of two rare arrhythmias in a young adult, who was admitted to our hospital twice within 6 months because of paroxysmal tachycardia. WPW syndrome and ILVT as underlying arrhythmias have been diagnosed and were ablated successfully.
This case highlights the diagnostic defiance of rare tachycardia entities and the paramount importance of ECG documentation and analysis of all available tachycardia ECGs.
预激综合征(WPW)和特发性左室性心动过速(ILVT)均较为罕见,目前这两种疾病共存的情况鲜有报道。在存在心室预激的患者中,阵发性心动过速的潜在机制很可能是房室折返性心动过速(AVRT)。然而,由于AVRT和ILVT临床表现相似,若没有心动过速发作时的心电图记录,则无法对潜在机制做出诊断。
我们报告了一名年轻成人先后两次发生两种罕见心律失常的病例。该患者因阵发性心动过速在6个月内两次入住我院。预激综合征和ILVT作为潜在心律失常被诊断出来,并成功进行了消融治疗。
该病例凸显了罕见心动过速实体的诊断挑战以及心电图记录和分析所有可用心动过速心电图的至关重要性。