Kajiyama Takatsugu, Hachiya Hitoshi, Iesaka Yoshito
Cardiovascular Center Tsuchiura Kyodo Hospital Tsuchiura Ibaraki Japan.
J Arrhythm. 2018 Jul 4;34(5):576-579. doi: 10.1002/joa3.12093. eCollection 2018 Oct.
An 18-year-old man without organic heart disease underwent catheter ablation for frequent monomorphic ventricular ectopic beats(VEBs). The origin of the VEB was presumed located on the left coronary cusp(LCC) regarding his electrocardiography. Local activation in the right ventricular outflow tract was not so early. On the LCC, four different prepotentials were obtained by slight relocation of the catheter. Finally, on the site with positive discrete prepotential recorded on the distal electrodes, an application of radiofrequency current immediately eliminated the VEB. Although LCC is considered as a small structure, detailed mapping may be important to find the most optimal ablation site.
一名无器质性心脏病的18岁男性因频发单形性室性早搏接受导管消融治疗。根据其心电图推测室性早搏起源于左冠状动脉窦(LCC)。右心室流出道的局部激动并不很早。在LCC上,通过轻微移动导管获得了四种不同的前电位。最后,在远端电极记录到正性离散前电位的部位,施加射频电流立即消除了室性早搏。尽管LCC被认为是一个小结构,但详细标测对于找到最佳消融部位可能很重要。