成功经右心室憩室消融 Wolff-Parkinson-White 综合征患者心外膜旁道。
Successful ablation of a right epicardial accessory pathway via the right ventricular diverticulum in a patient with Wolff-Parkinson-White syndrome.
机构信息
Department of Cardiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.
Cardiovascular Division, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
出版信息
J Cardiovasc Electrophysiol. 2023 May;34(5):1302-1304. doi: 10.1111/jce.15899. Epub 2023 Apr 23.
INTRODUCTION
We describe one rare case of successful ablation of a right epicardial accessory pathway (AP) via the right ventricular diverticulum in a patient with Wolff-Parkinson-White syndrome.
METHODS
A 42-year-old woman was referred to the hospital for a catheter ablation of Wolf-Parkinson-White syndrome. The earliest activation was shown to be present in the region of the tricuspid annulus. However, ablation had no effect on the AP.
RESULTS
We decided to do a selected angiography, in which a big diverticulum near the right tricuspid annulus was shown to be present. Ablation in this region successfully repressed the AP without any recurrences within a follow-up period of 12 months.
CONCLUSION
The ventricular diverticulum-mediated AP is a novel variant of pre-excitation. It can serve as an anatomical substrate of supraventricular tachycardia, and can be ablated endocardially using an irrigation tip catheter within the diverticulum.
简介
我们描述了一例通过右心室憩室成功消融右侧心外膜旁路（AP）的罕见病例，该患者患有 Wolff-Parkinson-White 综合征。
方法
一名 42 岁女性因 Wolff-Parkinson-White 综合征被转诊至医院进行导管消融。最早的激活显示存在于三尖瓣环区域。然而，消融对 AP 没有影响。
结果
我们决定进行选择性血管造影，显示在右三尖瓣环附近存在一个大憩室。在这个区域进行消融成功地抑制了 AP，在 12 个月的随访期间没有复发。
结论
心室憩室介导的 AP 是预激的一种新变体。它可以作为室上性心动过速的解剖学基础，并可使用憩室内的灌流尖端导管进行心内膜消融。
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