Horton R P, Canby R C, Kessler D J, Joglar J A, Hume A, Jessen M E, Scott W P, Page R L
Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas 75235-9047, USA.
J Cardiovasc Electrophysiol. 1997 Apr;8(4):432-5. doi: 10.1111/j.1540-8167.1997.tb00808.x.
Ventricular tachycardia is commonly seen in patients following surgical repair for tetralogy of Fallot. The technique of ablation for this arrhythmia is not well defined.
In two patients with ventricular tachycardia following surgical repair of tetralogy of Fallot, the traditional indicators for a site for ventricular tachycardia ablation did not yield cure. Based on careful mapping, the circuit was found to involve the isthmus between the outflow tract patch and the tricuspid annulus; linear radiofrequency lesions across this isthmus resulted in cure of ventricular tachycardia. Not only was the tachycardia no longer inducible, but bidirectional block at the line of ablation confirmed interruption of the reentrant circuit.
A linear radiofrequency lesion was effective in eliminating ventricular tachycardia in both patients. The demonstration of bidirectional block confirms a cure independent of inducibility of ventricular tachycardia.
室性心动过速常见于法洛四联症手术修复后的患者。这种心律失常的消融技术尚未明确。
在两名法洛四联症手术修复后出现室性心动过速的患者中，传统的室性心动过速消融部位指标未能实现治愈。通过仔细标测，发现折返环涉及流出道补片与三尖瓣环之间的峡部；横跨该峡部的线性射频消融导致室性心动过速治愈。不仅室性心动过速不再能被诱发，而且消融线处的双向阻滞证实了折返环的中断。
线性射频消融在两名患者中均有效消除了室性心动过速。双向阻滞的证实确认了治愈，而与室性心动过速的可诱发性无关。
