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希氏束旁起源隐匿性连接的左束支近端的窄 QRS 波心搏过速。

Narrow QRS ectopy with concealed connections from a para-Hisian origin to the proximal left fascicles.

机构信息

Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi City, Gunma, Japan.

Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan.

出版信息

J Cardiovasc Electrophysiol. 2024 Jun;35(6):1235-1241. doi: 10.1111/jce.16262. Epub 2024 Apr 8.

Abstract

INTRODUCTION

Catheter ablation of ectopy originating from the vicinity of the His bundle can be challenging.

METHODS AND RESULTS

We report a case of a 33-year-old man with narrow QRS ectopy with preferential conduction from a para-Hisian origin to the proximal left fascicles, which was successfully eliminated by radiofrequency ablation in the right coronary cusp, guided by ultrahigh-resolution mapping of the His bundle, bundle branch, and fascicular electrograms.

CONCLUSION

Some narrow QRS ectopy may originate from the vicinity of the conduction system, instead of the "true" conduction system, and have concealed connections from its origin to the conduction system.

摘要

介绍

希氏束附近起源的异位点导管消融可能具有挑战性。

方法和结果

我们报告了一例 33 岁男性,窄 QRS 异位点,起源于希氏束旁,优先传导至左前束支,通过希氏束、束支和束支电图的超高分辨率标测,在右冠状动脉瓣指导下,射频消融成功消除。

结论

一些窄 QRS 异位点可能起源于传导系统附近,而不是“真正”的传导系统,并且从其起源到传导系统存在隐蔽的连接。

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