束支性心动过速（折返性和非折返性）的标测与消融

Mapping and Ablation of Fascicular Tachycardias (Reentrant and Nonreentrant).

作者信息

Talib Ahmed Karim, Shenasa Mohammad

机构信息

Cardiac Electrophysiology Division, Najaf Center for Cardiac Surgery and Trans-catheter Therapy, Najaf city, Iraq; Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.

Heart and Rhythm Medical Group, 105 North Bascom Avenue, Suite 204, San Jose, CA 95128, USA.

出版信息

Card Electrophysiol Clin. 2019 Dec;11(4):609-623. doi: 10.1016/j.ccep.2019.08.004.

DOI:10.1016/j.ccep.2019.08.004

PMID:31706469

Abstract

Fascicular ventricular tachycardia (FVT) usually involves the left fascicular system; namely the left posterior fascicle, anterior fascicle, and rarely the upper septal fascicle. It may also involve the right Purkinje arborization. This tachycardia can be seen in normal heart or in the setting of structural heart diseases. Monomorphic FVT can be reentrant or nonreentrant and verapamil-sensitive left FVT is the second most common type of idiopathic ventricular tachycardia (VT) after right ventricular outflow tract VT. This article focuses on the practical approach for both reentrant and nonreentrant FVT, explaining the mechanism, electrocardiographic features, and electrophysiologic features of FVT.

摘要

分支型室性心动过速（FVT）通常累及左束支系统，即左后分支、前分支，很少累及上间隔分支。它也可能累及右束支树状分支。这种心动过速可见于正常心脏或结构性心脏病患者。单形性FVT可以是折返性或非折返性的，对维拉帕米敏感的左FVT是继右心室流出道室性心动过速（VT）之后第二常见的特发性室性心动过速类型。本文重点介绍折返性和非折返性FVT的实用诊疗方法，阐述FVT的机制、心电图特征和电生理特征。