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起源于希氏束的室性心动过速:一例报告。

Ventricular tachycardia originating from the His bundle: A case report.

作者信息

Zhang Lu-Yao, Dong Shu-Juan, Yu Hai-Jia, Chu Ying-Jie

机构信息

Department of Cardiology, Zhengzhou University People's Hospital, Zhengzhou 450003, Henan Province, China.

Department of Emergency, Zhengzhou University People's Hospital, Zhengzhou 450003, Henan Province, China.

出版信息

World J Clin Cases. 2021 Nov 16;9(32):10040-10045. doi: 10.12998/wjcc.v9.i32.10040.

Abstract

BACKGROUND

Ventricular tachycardia (VT) commonly occurs among patients with heart failure and can even cause sudden cardiac death. VT originating from the His bundle branch has been rarely reported. We present the case of a patient with VT from the His bundle branch.

CASE SUMMARY

A 58-year-old female complained of paroxysmal palpitations and dizziness for approximately 6 mo. She had a history of fatty liver and cholecystitis, and carotid atherosclerosis could not be excluded from the ultrasound results. An evaluation of the electrocardiogram obtained after admission showed spontaneous conversion between two different morphologies. The possible electrophysiologic mechanism suggested that the dual-source VT originated from the same source, the His bundle branch. Finally, the His bundle branch was ablated, and a dual-chamber pacemaker was inserted into the patient's heart. No further VT occurred during the 3-year follow-up after hospital discharge.

CONCLUSION

The diagnosis of VT originating from the His bundle is rare and difficult to establish. The results of this study showed VT originating from the His bundle based on a careful evaluation of the electrocardiogram, and the diagnosis was confirmed by an intracardiac electrophysiologic examination.

摘要

背景

室性心动过速(VT)常见于心力衰竭患者,甚至可导致心源性猝死。起源于希氏束分支的室性心动过速鲜有报道。我们报告一例起源于希氏束分支的室性心动过速患者。

病例摘要

一名58岁女性主诉阵发性心悸和头晕约6个月。她有脂肪肝和胆囊炎病史,超声检查结果不能排除颈动脉粥样硬化。入院后心电图评估显示两种不同形态之间自发转换。可能的电生理机制提示双源室性心动过速起源于同一部位,即希氏束分支。最后,对希氏束分支进行了消融,并在患者心脏植入了双腔起搏器。出院后3年随访期间未再发生室性心动过速。

结论

起源于希氏束的室性心动过速诊断罕见且难以确立。本研究结果通过对心电图的仔细评估显示为起源于希氏束的室性心动过速,并经心内电生理检查确诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8404/8610906/e945c8de0053/WJCC-9-10040-g001.jpg

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