Spies Christian, Neef Martin
Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstraße 20, 04103, Leipzig, Deutschland.
Herzschrittmacherther Elektrophysiol. 2021 Mar;32(1):128-132. doi: 10.1007/s00399-020-00736-1. Epub 2021 Jan 15.
We report the case of a 30-year-old man who presented to our emergency department with rapid heart beat and a narrow complex tachycardia at a rate of 215 beats per minute. With the working diagnosis of Wolf-Parkinson-White syndrome with paroxysmal orthodromic tachycardias, we performed an electrophysiological study. In this examination, there was a para-Hisian accessory pathway with very fast, prognostically relevant conduction properties. In order to protect the His bundle that is located deeper in the tissue and to avoid a deeper lesion, we decided to use high-power short-duration ablation. This method, which was recently used in three-dimensional-controlled radiofrequency ablation of pulmonary veins, causes more superficial lesions in order to protect the surrounding tissue. In our case, using the high-power short-duration method, we were able to successfully ablate the para-Hisian accessory pathway, while protecting the His bundle near the ablation site.
我们报告了一名30岁男性的病例，他因心跳过速和每分钟215次的窄QRS波心动过速前来我院急诊科就诊。初步诊断为预激综合征伴阵发性顺向型心动过速，我们进行了电生理检查。在此次检查中，发现一条希氏束旁旁路，其传导速度非常快，具有重要的预后意义。为了保护位于组织深处的希氏束并避免造成更深的损伤，我们决定采用高能量短时间消融术。这种方法最近用于肺静脉的三维可控射频消融，可造成更表浅的损伤以保护周围组织。在我们的病例中，采用高能量短时间方法，我们成功消融了希氏束旁旁路，同时保护了消融部位附近的希氏束。
