Zhang Shuang, Li Jianming, Tan Changming, Chen Mingxian, Hu Lin, Tang Hanze, Liao Liyi, Li Xuping
Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Nuclear Medicine Department, Tianjin Medical University Clinical Cardiovascular Institute, TEDA International Cardiovascular Hospital, Tianjin, China.
Front Surg. 2025 Jan 7;11:1449007. doi: 10.3389/fsurg.2024.1449007. eCollection 2024.
We report a case of a patient with dilated cardiomyopathy who experienced recurrent ventricular tachycardia (VT) and multiple defibrillations following CRT-D implantation. Due to worsening cardiac function, the patient required surgical implantation of a left ventricular assist device (LVAD) as a bridge to heart transplantation. During the procedure, we used the Ensite three-dimensional mapping system to perform activation and substrate mapping of the VT targets, followed by endocardial and epicardial cryoballoon ablation of clinical VT. Subsequently, during LVAD implantation, dual cryoballoon ablation was applied around the surgical incision site to prevent VT associated with the surgical wound and the implanted device. At the 1-year follow-up, the patient had no recurrence of the original clinical VT and no new ventricular arrhythmias were observed.
我们报告了一例扩张型心肌病患者，该患者在植入心脏再同步化治疗除颤器（CRT-D）后出现反复室性心动过速（VT）并接受了多次除颤。由于心功能恶化，患者需要手术植入左心室辅助装置（LVAD）作为心脏移植的过渡。在手术过程中，我们使用Ensite三维标测系统对VT靶点进行激动和基质标测，随后对临床VT进行心内膜和心外膜冷冻球囊消融。随后，在植入LVAD期间，在手术切口部位周围进行双冷冻球囊消融，以预防与手术伤口和植入装置相关的VT。在1年的随访中，患者原临床VT未复发，也未观察到新的室性心律失常。
