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室性心动过速的两面性:单环双出口。

The Janus Heads of ventricular Tachycardia: Single-circuit with dual exits.

作者信息

Bisht Devendra S, Kishor Kamal

机构信息

Mukat Hospital & Heart Institute, Chandigarh, India.

出版信息

Indian Pacing Electrophysiol J. 2024 Nov-Dec;24(6):337-346. doi: 10.1016/j.ipej.2024.08.005. Epub 2024 Aug 31.

Abstract

In the setting of ischemic heart disease (IHD), ventricular tachycardia (VT) commonly originates from areas of incomplete scar tissue. High-density electroanatomic mapping has enhanced our understanding of VT circuits, predominantly characterised by dense scar and surviving myocyte bundles. We present a case of a 58-year-old male with IHD and sustained monomorphic VT, successfully treated with radiofrequency ablation following high-density mapping and entrainment techniques. Two inducible VT phenotypes were identified, with ablation at one site effectively terminating both VT morphologies. This case illustrates the importance of precise circuit localisation and targeted ablation in managing post-infarction VT, leading to a satisfactory patient outcome.

摘要

在缺血性心脏病(IHD)的背景下,室性心动过速(VT)通常起源于不完全瘢痕组织区域。高密度电解剖标测增强了我们对VT环路的理解,其主要特征是致密瘢痕和存活的心肌细胞束。我们报告一例58岁男性IHD患者,伴有持续性单形性VT,在高密度标测和拖带技术后成功接受射频消融治疗。识别出两种可诱导的VT表型,在一个部位进行消融可有效终止两种VT形态。该病例说明了精确的环路定位和靶向消融在管理心肌梗死后VT中的重要性,从而使患者获得满意的治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/882d/11662398/fe1de08cf2db/gr1.jpg

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