Yakubov Akmal, Salayev Oybek, Hamrayev Ramesh, Sultankhonov Sardorkhon
Department of Electrophysiology, Republican Scientific Centre of Cardiology, Yunus Abad, 19 District, 19th Building, 23 Apt., Tashkent, Uzbekistan.
Eur Heart J Case Rep. 2018 Oct 18;2(4):yty110. doi: 10.1093/ehjcr/yty110. eCollection 2018 Dec.
Although premature ventricular complexes and ventricular tachycardia (VT) from outflow tracts are easy to map and ablate, some foci create the greatest challenges for the electrophysiologist. One such example is the 'Bermuda triangle' of the heart.
In this article, we describe the rarely used but acceptable approach to the 'Bermudian' focus. We present a case of a 38-year-old male patient with sustained monomorphic VT, who underwent radiofrequency ablation of arrhythmogenic myocardium. After unsuccessful ablation through the posterior right ventricular outflow tract (RVOT), left coronary cusp (LCC), and distal coronary sinus, tachycardia was eliminated from the left atrial appendage (LAA). Complaints such as palpitations and weakness disappeared after the procedure.
Radiofrequency ablation of VT might be performed using LAA. This approach is used when the epicardial location of arrhythmia-causing tissue is suspected and ablation through the RVOT, LCC, and great cardiac vein fails.
尽管起源于流出道的室性早搏和室性心动过速（VT）易于标测和消融，但有些病灶给电生理学家带来了极大挑战。心脏的“百慕大三角”就是这样一个例子。
在本文中，我们描述了针对“百慕大”病灶的一种很少使用但可接受的方法。我们介绍了一名38岁男性持续性单形性室性心动过速患者的病例，该患者接受了致心律失常心肌的射频消融治疗。在经右心室流出道（RVOT）后壁、左冠状动脉窦（LCC）和冠状静脉窦远端消融失败后，从左心耳（LAA）消除了心动过速。术后心悸和乏力等症状消失。
室性心动过速的射频消融可使用左心耳进行。当怀疑致心律失常组织位于心外膜且经右心室流出道、左冠状动脉窦和冠状大静脉消融失败时，可采用这种方法。
