左侧罕见的附加旁路经房间隔左心房侧卵圆窝部位成功消融。
Rare left-sided accessory pathway successfully ablated with atrial insertion site at the left-side fossa ovalis.
机构信息
Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China.
Department of Cardiology, Mongolian Autonomous County of Qian Gorlos Hospital, Songyuan, China.
出版信息
J Cardiovasc Electrophysiol. 2022 Oct;33(10):2224-2227. doi: 10.1111/jce.15634. Epub 2022 Sep 7.
INTRODUCTION
Left-sided accessory pathway (AP) with atrial insertion away from the annulus is an atypical variation. Conventional mapping and ablation performed along mitral annulus (MA) is usually ineffective.
METHODS
A 14-year-old girl without structural heart disease presented with recurrent episodes of sudden onset palpitations and electrocardiogram (ECG) showed a narrow QRS complex tachycardia.
RESULTS
Electrophysiology study (EPS) was done and anterograde atrioventricular reentrant tachycardia (AVRT) with AP was diagnosed. Conventional mapping and ablation performed along TA and MA was failed. 3D-activation mapping found the retrograde atrial insertion site of AP on the left atrium fossa ovalis (FO), and AP was successfully abolished by radiofrequency ablation at that site.
CONCLUSION
As reported, this patient is the first report of ablating a left-sided AP with retrograde atrial insertion on the left atrium FO.
介绍
左心耳旁的左侧附加道（AP）具有非典型的心房插入部位。沿着二尖瓣环（MA）进行的常规映射和消融通常是无效的。
方法
一名 14 岁女孩没有结构性心脏病，表现为反复出现的突发性心悸，心电图（ECG）显示窄 QRS 心动过速。
结果
进行电生理研究（EPS），诊断为逆行性房室折返性心动过速（AVRT）伴 AP。沿着 TA 和 MA 进行的常规映射和消融失败。3D 激活映射在左心房卵圆窝（FO）上发现了 AP 的逆行心房插入部位，并在该部位成功进行了射频消融消融。
结论
据报道，该患者是首例报道消融左心耳旁逆行心房插入的左侧 AP。
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