Wallet Justin, Kimura Yoshitaka, Zeppenfeld Katja
Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Postbus 9600, Leiden 2300 RC, the Netherlands; Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL), the Netherlands; Willem Einthoven Center of Arrhythmia Research and Management.
Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Postbus 9600, Leiden 2300 RC, the Netherlands; Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL), the Netherlands; Willem Einthoven Center of Arrhythmia Research and Management.
Card Electrophysiol Clin. 2022 Dec;14(4):709-727. doi: 10.1016/j.ccep.2022.06.008. Epub 2022 Oct 28.
Patients with congenital heart disease (CHD) are at risk for late ventricular tachycardia (VT) and sudden cardiac death. Slow conducting anatomical isthmuses, bordered by unexcitable tissue created by valve annuli, ventricular incisions, and prosthetic material are the dominant substrate for macroreentrant monomorphic VTs in repaired CHD. These well-defined substrates allow for catheter or surgical transection with clear endpoints. This review elaborates on VT substrates in various CHD, and evolving mapping and ablation approaches. Because most research is conducted in patients with repaired tetralogy of Fallot, this malformation will serve as a paradigm.
先天性心脏病（CHD）患者存在晚期室性心动过速（VT）和心源性猝死的风险。缓慢传导的解剖学峡部，由瓣膜环、心室切口和人工材料形成的不可兴奋组织所界定，是修复后的CHD中宏观折返性单形性VT的主要基质。这些明确界定的基质允许进行导管或手术横断，并有明确的终点。本综述阐述了各种CHD中的VT基质，以及不断发展的标测和消融方法。由于大多数研究是在法洛四联症修复患者中进行的，这种畸形将作为一个范例。
