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心脏再同步化治疗除颤器成功治疗系统性硬化症合并室性心动过速:一例报告

Successful treatment of systemic sclerosis complicated by ventricular tachycardia with a cardiac resynchronization therapy-defibrillator: A case report.

作者信息

Chen Yuan-Yuan, Yan Hui, Zhu Jian-Hua

机构信息

Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.

出版信息

World J Clin Cases. 2020 Mar 26;8(6):1129-1136. doi: 10.12998/wjcc.v8.i6.1129.

Abstract

BACKGROUND

Systemic sclerosis is a rare connective tissue disease characterized by localized or diffuse skin thickening and fibrosis, which usually accumulates in various organs throughout the body. Tachyarrhythmia is a common clinical manifestation of cardiovascular damage in systemic sclerosis patients. However, few studies have reported the use of catheter ablation and an implantable cardioverter defibrillator in patients with systemic sclerosis complicated by ventricular tachycardia.

CASE SUMMARY

A 39-year woman with an 11-year history of systemic sclerosis was referred to our hospital due to three syncopal episodes in the past 6 mo. The results of an electrocardiogram and a transthoracic echocardiogram revealed ventricular tachycardia and left ventricular systolic and ventricular septum segmental motion abnormalities, respectively. The results of an electrocardiogram showed a sinus rhythm with complete blockage of the left bundle branch. In light of the progressive nature of systemic sclerosis, the presence of a left bundle branch block, and the decreased ejection fraction, a cardiac resynchronization therapy-defibrillator was implanted. The patient's clinical conditions improved, and at the 3-mo follow-up, the patient was free of ventricular tachycardia and all cardiac symptoms.

CONCLUSION

We report the first case of systemic sclerosis complicated by ventricular tachycardia that was successfully treated with a cardiac resynchronization therapy-defibrillator.

摘要

背景

系统性硬化症是一种罕见的结缔组织疾病,其特征为局部或弥漫性皮肤增厚和纤维化,通常累及全身各个器官。快速性心律失常是系统性硬化症患者心血管损害的常见临床表现。然而,很少有研究报道在系统性硬化症合并室性心动过速的患者中使用导管消融和植入式心脏复律除颤器。

病例摘要

一名有11年系统性硬化症病史的39岁女性,因过去6个月内发生3次晕厥发作而转诊至我院。心电图和经胸超声心动图结果分别显示室性心动过速和左心室收缩及室间隔节段性运动异常。心电图结果显示窦性心律伴左束支完全阻滞。鉴于系统性硬化症的进行性、左束支阻滞的存在以及射血分数降低,植入了心脏再同步化治疗除颤器。患者的临床状况得到改善,在3个月的随访中,患者未出现室性心动过速及所有心脏症状。

结论

我们报告了首例系统性硬化症合并室性心动过速并成功接受心脏再同步化治疗除颤器治疗的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d16/7103982/1563dfe4cb6d/WJCC-8-1129-g001.jpg

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