Kodali Santhisri, Santangeli Pasquale, Garcia Fermin C
Cardiac Electrophysiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, 9 Founders Pavilion, Philadelphia, PA 19104, USA.
Cardiac Electrophysiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, 9 Founders Pavilion, Philadelphia, PA 19104, USA.
Card Electrophysiol Clin. 2019 Dec;11(4):665-674. doi: 10.1016/j.ccep.2019.08.012.
Despite advances in our understanding of the relevant anatomy and mapping and catheter ablation techniques of idiopathic outflow tract ventricular arrhythmias, challenging sites for catheter ablation remain the aortic cusps, pulmonary artery, and notably the left ventricular summit. A systematic approach should be used to direct mapping efforts efficiently between endocardial, coronary venous, and epicardial sites. Foci at the left ventricular summit, particularly intraseptal and at the inaccessible epicardial region, remain difficult to reach and when percutaneous techniques fail, surgical ablation remains an option but with risk of late coronary artery stenosis.
尽管我们对特发性流出道室性心律失常的相关解剖结构以及标测和导管消融技术的理解有所进步，但导管消融的挑战性部位仍然是主动脉瓣叶、肺动脉，尤其是左心室心尖。应采用系统方法，以便在内膜、冠状静脉和心外膜部位之间有效地指导标测工作。左心室心尖处的病灶，尤其是间隔内和难以到达的心外膜区域的病灶，仍然难以触及，当经皮技术失败时，手术消融仍是一种选择，但存在晚期冠状动脉狭窄的风险。
