Electrocardiology Department, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico.
J Interv Card Electrophysiol. 2021 Dec;62(3):495-497. doi: 10.1007/s10840-021-01015-w. Epub 2021 Jul 8.
Atrial tachycardias originated at the left atrial appendage (LAA) are uncommon; often they are incessant and might induce tachycardiomyopathy, as discussed by Hillock et al. (Heart Rhythm;3(4):467-469, 2006). A case of a 21-year-old woman with incessant atrial tachycardia is presented, refractory to medical therapy, echocardiography showed global dilation with LV ejection fraction of 20%. After two failed endocardial ablations, an epicardial access was attempted. The earliest activation site was located at the tip of the epicardial aspect of the LAA. RFCA was successful at this site. The patient remains asymptomatic during a follow-up of 10 months; the ventricular function was completely recovered after 6 months (LVEF of 50%).
起源于左心耳（LAA）的房性心动过速并不常见；通常它们是无休止的，可能会引起心动过速性心肌病，正如 Hillock 等人所讨论的那样（Heart Rhythm；3(4):467-469, 2006）。本文报告了一例 21 岁女性患者，其无休止的房性心动过速对药物治疗无效，超声心动图显示左心室射血分数为 20%，呈全心扩张。在两次心内膜消融失败后，尝试了心外膜入路。最早的激活部位位于心外膜左心耳尖端。在此部位行射频消融术成功。患者在 10 个月的随访期间无症状；6 个月后心室功能完全恢复（LVEF 为 50%）。
