右心室流出道憩室起源的室性心动过速继发室性早搏1例A case of ventricular premature/ventricular tachycardia originating from right ventricular outflow tract diverticulum
黄强辉,章艳平,詹碧鸣,陈琦,胡金柱
摘要(Abstract):
右心室流出道憩室内起源的室性心律失常在国内外少有报道。本病例报道1例中老年男性患者,急性起病,表现为“无休止持续性室性心动过速”入院,术中标测时发现右心室流出道存在一异常畸形的解剖结构。根据阻抗值变化,并结合术中造影,考虑右心室流出道憩室,再通过多种标测方法,证实为憩室内起源的室性心动过速,经谨慎选择消融方式后,达到即刻成功,无手术并发症发生。随访无室性早搏或室性心动过速再发。通过本病例,笔者认为心律失常介入的每一环节,需细微缜密的观察、分析,方可对临床病例的实施起到积极的指导意义。
关键词(KeyWords): 憩室;右心室流出道;室性心律失常
基金项目(Foundation):
作者(Author): 黄强辉,章艳平,詹碧鸣,陈琦,胡金柱
参考文献(References):
- [1]桑才华,李梦梦,龙德勇,等.左心室乳头肌起源室性心律失常的电生理特征及导管消融[J].中国介入心脏病学杂志,2020,28(3):126-131. DOI:10.3969/j.issn.1004-8812.2020.03.002.
- [2] Zhang F,Yang B,Chen H,et al. Catheter ablation of ventricular tachycardia orignating from the diverticulum of the right ventuicular outflow tract[J]. Europace,2011,13(7):1047-1050. DOI:10.1093/europace/eur020.
- [3] Martini B,Trevisi N,Martini N,et al. Right ventricular outfl ow tract tachycardia with structural abnormalities of the right ventricle and left ventricular diverticulum[J]. Case Rep Cardiol,2015,2015:708687. DOI:10.1155/2015/708687.
- [4] Yang Q,He S,Cui K.Multiple monomorphic VTs from diverticulum in RVOT[J]. Europace,2014,16(4):532.DOI:10.1093/europace/eut234.
- [5] Romagnoli A,Ricci A,Morosetti D,et al.Congenital left ventricular diverticulum:multimodality imaging evaluation and literatute riview[J]. J Saudi Heart Assoc,2015,27(1):61-67. DOI:10.1016/j.jsha.2014.07.004.
- [6] Yamauchi Y,Nogami A,Naito S,et al.Catheter ablation for ventricular tachycardia from a diverticulum at the ventricular outflow tract[J]. Pacing Clin Electrophysiol,1998,21(9):1835-1836. DOI:10.1111/j.1540-8159.1998.tb00289.x.