Takasugi Nobuhiro, Yamada Takumi, Naruse Genki, Nakashima Takashi, Kanamori Hiromitsu, Okura Hiroyuki
Division of Cardiovascular Medicine Gifu University Hospital Gifu Japan.
Cardiovascular Division University of Minnesota Minneapolis Minnesota USA.
J Arrhythm. 2021 Dec 27;38(1):171-173. doi: 10.1002/joa3.12673. eCollection 2022 Feb.
A ventricular tachycardia (VT) with a left bundle branch block (BBB) pattern exhibited the earliest activation (EA) at the left ventricular basal septum near the His bundle with no excellent pace map (PM). Radiofrequency ablation at the right ventricular basal septum (opposite site of the EA site) changed the QRS morphology of VT to a right BBB pattern that matched a PM at the opposite site in the left ventricle. VT ablation was successful at the earliest activation site. The VT should have originated from an intramural origin with preferential pathways to the endocardial breakout sites in the right and left ventricular septum.
呈左束支传导阻滞（BBB）图形的室性心动过速（VT）在希氏束附近的左心室基底间隔表现出最早激动（EA），且无良好的起搏标测（PM）。在右心室基底间隔（EA部位的对侧）进行射频消融后，VT的QRS形态变为右束支传导阻滞图形，与左心室对侧部位的PM相匹配。VT在最早激动部位消融成功。该VT可能起源于心肌内，具有优先传导至右、左心室间隔心内膜突破部位的传导途径。
