特发性左前分支性心动过速的射频消融术
Radiofrequency ablation of idiopathic left anterior fascicular tachycardia.
作者信息
Bogun F, El-Atassi R, Daoud E, Man K C, Strickberger S A, Morady F
机构信息
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, USA.
出版信息
J Cardiovasc Electrophysiol. 1995 Dec;6(12):1113-6. doi: 10.1111/j.1540-8167.1995.tb00389.x.
INTRODUCTION
A 45-year-old man with idiopathic ventricular tachycardia (VT) having a right bundle branch block configuration with right-axis deviation underwent an electrophysiologic test.
METHODS AND RESULTS
Mapping demonstrated a site on the anterobasal wall of the left ventricle where there was an excellent pace map and an endocardial activation time of -20 msec, but radiofrequency catheter ablation at this site was unsuccessful. At a nearby site, a presumed Purkinje potential preceded the by 30 msec during VT and sinus rhythm, and catheter ablation was effective despite a poor pace map and an endocardial ventricular activation time of zero.
CONCLUSION
Idiopathic VT with a right bundle branch configuration and right-axis deviation may originate in the area of the left anterior fascicle. A potential presumed to represent a Purkinje potential may be more helpful than endocardial ventricular activation mapping or pace mapping in guiding ablation of this type of VT.
引言
一名45岁患有特发性室性心动过速（VT）且呈右束支阻滞形态伴电轴右偏的男性接受了电生理检查。
方法与结果
标测显示左心室前壁基底有一个部位，在此处起搏标测效果极佳，心内膜激动时间为-20毫秒，但在此部位进行射频导管消融未成功。在附近一个部位，在室性心动过速和窦性心律时，一个推测的浦肯野电位比QRS波提前30毫秒，尽管起搏标测效果不佳且心内膜心室激动时间为零，但导管消融仍有效。
结论
呈右束支阻滞形态伴电轴右偏的特发性室性心动过速可能起源于左前分支区域。在指导此类室性心动过速的消融时，一个推测代表浦肯野电位的电位可能比心内膜心室激动标测或起搏标测更有帮助。
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