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[体外膜肺氧合辅助下的室性心动过速消融术。我院的首例经验]

[Ablation of ventricular tachycardia assisted with ECMO. First experience in our institution].

作者信息

Losantos-Saavedra Carla A, Bustillos-García Gabriela A, Catrip-Torres Jorge M, Nava Santiago

机构信息

Departamento de Electrofisiología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.

Unidad de Cirugía Cardiaca. Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.

出版信息

Arch Cardiol Mex. 2022 Jul 1;92(3):358-361. doi: 10.24875/ACM.21000059.

DOI:10.24875/ACM.21000059
PMID:35358378
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9262304/
Abstract

Catheter ablation is useful for reducing drug refractory ventricular tachycardia (VT) episodes and can be life-saving when VT is incessant or arrhythmic storm. Left ventricular hemodynamic support may be required in patients with VT and hemodynamic instability. Extracorporeal membrane oxygenation (ECMO) support is an alternative to achieve ventricular tachycardia mapping and ablation over long periods of time. We present a case of successful catheter ablation of substrate in a patient with ischemic heart disease and ventricular tachycardia with hemodynamic instability performed using venous- arterial ECMO support. There were not episodes of ventricular tachycardia after 2 years of follow-up.

摘要

导管消融术对于减少药物难治性室性心动过速（VT）发作很有用，当VT持续发作或出现心律失常风暴时，它可能挽救生命。VT伴血流动力学不稳定的患者可能需要左心室血流动力学支持。体外膜肺氧合（ECMO）支持是一种可用于长时间进行室性心动过速标测和消融的替代方法。我们报告一例缺血性心脏病合并室性心动过速伴血流动力学不稳定患者，使用静脉-动脉ECMO支持成功进行了基质导管消融术。随访2年后未再出现室性心动过速发作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/368a/9262304/4844968e3e94/6936AX213-ACM-92-358-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/368a/9262304/862926b4ef77/6936AX213-ACM-92-358-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/368a/9262304/4844968e3e94/6936AX213-ACM-92-358-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/368a/9262304/862926b4ef77/6936AX213-ACM-92-358-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/368a/9262304/4844968e3e94/6936AX213-ACM-92-358-g002.jpg

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本文引用的文献

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Mechanical circulatory support for life-threatening arrhythmia: A systematic review.用于危及生命的心律失常的机械循环支持：一项系统综述。
Int J Cardiol. 2020 Jun 1;308:42-49. doi: 10.1016/j.ijcard.2020.03.045. Epub 2020 Mar 19.
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Extracorporeal membrane oxygenation for hemodynamic support of ventricular tachycardia ablation: a 2-center experience.体外膜肺氧合用于室性心动过速消融的血流动力学支持：一项两中心经验
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Extracorporeal Membrane Oxygenation for Hemodynamic Support of Ventricular Tachycardia Ablation.用于室性心动过速消融血流动力学支持的体外膜肺氧合
Circ Arrhythm Electrophysiol. 2016 Dec;9(12). doi: 10.1161/CIRCEP.116.004492.
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Bipolar irrigated radiofrequency ablation of resistant ventricular tachycardia with a septal intramural origin: the initial experience and a description of the method.双极灌注射频消融治疗起源于室间隔壁内的顽固性室性心动过速：初步经验及方法描述
Clin Case Rep. 2016 Aug 25;4(10):957-961. doi: 10.1002/ccr3.648. eCollection 2016 Oct.
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Substrate-Based Ablation Versus Ablation Guided by Activation and Entrainment Mapping for Ventricular Tachycardia: A Systematic Review and Meta-Analysis.基于基质的消融与激动和拖带标测指导的消融治疗室性心动过速：一项系统评价和荟萃分析
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Catheter ablation for ventricular tachycardia in ischaemic heart disease; acute success and long-term outcome.缺血性心脏病伴室性心动过速的导管消融治疗：即刻成功率与远期预后。
Scand Cardiovasc J. 2014 Feb;48(1):27-34. doi: 10.3109/14017431.2013.877154. Epub 2014 Jan 27.
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Management of ventricular tachycardia in the setting of a dedicated unit for the treatment of complex ventricular arrhythmias: long-term outcome after ablation.复杂室性心律失常治疗专责单位中心律失常的治疗：消融后的长期结果
Circulation. 2013 Apr 2;127(13):1359-68. doi: 10.1161/CIRCULATIONAHA.112.000872. Epub 2013 Feb 25.