Sato M, Sakurai M, Yotsukura A, Betsuyaku T, Ito T, Yoshida I, Kitabatake A
Department of Cardiovascular Medicine, Hokkaido University, School of Medicine, Sapporo, Japan.
Jpn Circ J. 1997 Jan;61(1):55-63. doi: 10.1253/jcj.61.55.
We performed radiofrequency catheter ablation (RF ablation) for ventricular tachycardia (VT) in 2 patients with dilated cardiomyopathy (DCM) and 1 patient with arrhythmogenic right ventricular dysplasia (ARVD). Patient 1 had incessant VT associated with DCM. RF ablation was performed where diastolic potentials were recorded and concealed entrainment was demonstrated. VT was terminated by RF ablation. Patient 2 had drug-resistant VT associated with ARVD. RF ablation was performed where perfect pace-mapping was obtained during sinus rhythm, diastolic potentials were recorded and concealed entrainment was demonstrated. VT was terminated by RF ablation. Patient 3 had 2 morphologically distinct VTs associated with DCM. The target for RF ablation was 1 of the 2, which was a drug-resistant type. Perfect pace mapping was obtained where delayed potentials were recorded. As the current strength of pacing was reduced, the QRS complex configuration switched to the other type. This site was thought to be the common slow conduction zone for the re-entry circuit of the 2 types and RF ablation was performed at this site. In these 3 cases, VT did not recur after ablation. RF ablation is effective for the treatment of VT associated with cardiomyopathy.
我们对2例扩张型心肌病（DCM）患者和1例致心律失常性右室发育不良（ARVD）患者的室性心动过速（VT）进行了射频导管消融（RF消融）。患者1患有与DCM相关的持续性VT。在记录到舒张期电位并证实存在隐匿性拖带的部位进行了RF消融。VT通过RF消融终止。患者2患有与ARVD相关的药物难治性VT。在窦性心律期间获得完美起搏标测、记录到舒张期电位并证实存在隐匿性拖带的部位进行了RF消融。VT通过RF消融终止。患者3患有与DCM相关的2种形态不同的VT。RF消融的靶点是其中1种，为药物难治性类型。在记录到延迟电位的部位获得了完美起搏标测。随着起搏电流强度降低，QRS波群形态转变为另一种类型。该部位被认为是这2种类型折返环的共同缓慢传导区，并在此部位进行了RF消融。在这3例患者中，消融后VT未复发。RF消融对心肌病相关VT的治疗有效。
