Wiener I, Mindich B, Pitchon R
Am Heart J. 1984 Jan;107(1):86-90. doi: 10.1016/0002-8703(84)90138-8.
Eight patients with ventricular aneurysms and ventricular tachycardia refractory to drugs were studied. Each patient underwent intraoperative epicardial and endocardial mapping during stable sinus rhythm. After aneurysmectomy, areas of the endocardial border zone which demonstrated fragmented activity were excised. Mapping was then repeated to ensure that major areas of fragmentation did not remain. Mapping was completed in less than 20 minutes in each patient. One patient died of pump failure before hospital discharge and a second patient, who was arrhythmia-free, died of pump failure 12 months postoperatively. Six patients are alive and free of ventricular tachycardia 5 to 25 months (mean 11.5) postoperatively. We conclude that excision of areas of fragmented electrical activity in the endocardial border zone of ventricular aneurysms is a useful approach to surgical therapy for ventricular tachycardia. This approach allows an excision directed to arrhythmogenic areas without the need for tachycardia induction in the operating room.
对8例患有心室壁瘤且药物治疗难治性室性心动过速的患者进行了研究。每位患者在窦性心律稳定期间接受了术中的心外膜和心内膜标测。在切除心室壁瘤后，切除了显示碎裂电活动的心内膜边缘区。然后重复标测以确保不存在主要的碎裂区域。每位患者的标测在不到20分钟内完成。1例患者在出院前死于泵衰竭，另1例无心律失常的患者在术后12个月死于泵衰竭。6例患者术后5至25个月（平均11.5个月）存活且无室性心动过速。我们得出结论，切除心室壁瘤心内膜边缘区的碎裂电活动区域是治疗室性心动过速的一种有效手术方法。这种方法能够直接切除致心律失常区域，而无需在手术室诱发心动过速。
