Chinushi M, Aizawa Y, Kitazawa H, Kusano Y, Washizuka T, Shibata A
First Department of Internal Medicine, Niigata University School of Medicine, Japan.
Pacing Clin Electrophysiol. 1995 Sep;18(9 Pt 1):1713-6. doi: 10.1111/j.1540-8159.1995.tb06994.x.
Radiofrequency (RF) catheter ablation was applied to two macroreentrant ventricular tachycardias (VTs) documented after corrective operation for tetralogy of Fallot. The activation wavefront of VT with a right bundle branch block pattern was found to revolve in a clockwise manner around a presumed myotomy scar in the right ventricle, and VT with a left bundle branch block pattern revolved around the same anatomical obstacle in a counterclockwise manner. In both VTs, the biggest conduction delay was confirmed at the right ventricular outflow tract. RF applications to the slow conduction area terminated each VT within a few seconds but were insufficient to cure the VTs. RF lesions were then applied to the slow conduction area in a line to intersect the macroreentrant circuit, and both VTs became noninducible.
对法洛四联症矫正手术后记录到的两例大折返性室性心动过速（VT）进行了射频（RF）导管消融。发现呈右束支传导阻滞图形的VT的激动波前围绕右心室中一个假定的肌切开瘢痕呈顺时针方向旋转，而呈左束支传导阻滞图形的VT围绕同一解剖学障碍呈逆时针方向旋转。在这两例VT中，最大传导延迟均在右心室流出道得到证实。对缓慢传导区域进行射频消融在数秒内终止了每一例VT，但不足以治愈VT。然后沿一条线对缓慢传导区域进行射频消融以与大折返环路相交，两例VT均不能被诱发。
