Abdelfattah Mahmoud, Ahmed Eslam, Nasr Ahmed, El Husseny Mostafa, Kamel Omnia
Magdi Yacoub Heart Foundation, Cairo, Egypt.
Kafrelsheikh University, Kafr El-Sheikh, Egypt.
BMC Cardiovasc Disord. 2024 Dec 30;24(1):752. doi: 10.1186/s12872-024-04290-3.
Premature ventricular contractions (PVCs) are a common finding in patients with surgically repaired congenital heart defects including transposition of the great arteries (D-TGA). While often asymptomatic, PVCs can sometimes lead to palpitations, dyspnea, and hemodynamic compromise, requiring therapeutic intervention. The arterial switch operation is the preferred treatment for D-TGA, but these patients have a 2% incidence of ventricular arrhythmias and 1% incidence of sudden cardiac death post-operatively. Though radio-frequency ablation is an effective option for treating outflow ventricular arrhythmias, little data is available on its use in the post-arterial switch D-TGA population. This case report describes a successful catheter ablation of frequent PVCs originating from the left ventricular summit region in a 9-year-old child with a history of arterial switch repair for D-TGA and frequent monomorphic PVCs, highlighting the challenges and considerations in managing ventricular arrhythmias in this complex anatomical setting.
室性早搏（PVCs）在接受手术修复的先天性心脏缺陷患者中很常见，包括大动脉转位（D-TGA）。虽然通常无症状，但PVCs有时会导致心悸、呼吸困难和血流动力学损害，需要进行治疗干预。动脉调转术是D-TGA的首选治疗方法，但这些患者术后发生室性心律失常的发生率为2%，心源性猝死的发生率为1%。尽管射频消融是治疗流出道室性心律失常的有效选择，但关于其在动脉调转术后D-TGA人群中的应用数据很少。本病例报告描述了一名9岁儿童成功进行导管消融治疗起源于左心室顶部区域的频发PVCs，该儿童有D-TGA动脉调转修复病史且频发单形性PVCs，突出了在这种复杂解剖结构中管理室性心律失常的挑战和注意事项。
