CAJ | 학술논문

目的报道7例室性心动过速(VT)合并室上性心动过速(SVT)的射频消融.方法 7例患者男6例,女1例,平均年龄(21±9)岁.阵发性心动过速病史(3.7±2.0)年.术中心房和心室刺激诱发VT和SVT,并进行消融.结果 7例患者心房或心室刺激能反复诱发和终止VT合并SVT.法洛四联症矫治术后右心室VT合并三尖瓣环峡部依赖性心房扑动(AFL)1例,其余6例均为维拉帕米敏感性左心室特发性室速(ILVT),分别合并AFL 1例,左后间隔旁路参与的顺向型房室折返性心动过速(AVRT)1例,冠状静脉窦口慢旁路参与的顺向型AVRT 1例,慢慢型房室结折返性心动过速(AVNRT)1例,左侧游离壁旁路参与的顺向型AVRT 2例.7例患者的两种心动过速均成功消融,所有患者消融术后随访2年,无一例VT或SVT复发.结论 VT合并SVT并不少见,消融术中应放置必需的心腔内电极导管,完成详细电生理检查,避免漏诊.一次消融应根除两种疾病.
목적 보도7례실성심동과속(VT)합병실상성심동과속(SVT)적사빈소융.방법 7례환자남6례,녀1례,평균년령(21±9)세.진발성심동과속병사(3.7±2.0)년.술중심방화심실자격유발VT화SVT,병진행소융.결과 7례환자심방혹심실자격능반복유발화종지VT합병SVT.법락사련증교치술후우심실VT합병삼첨판배협부의뢰성심방복동(AFL)1례,기여6례균위유랍파미민감성좌심실특발성실속(ILVT),분별합병AFL 1례,좌후간격방로삼여적순향형방실절반성심동과속(AVRT)1례,관상정맥두구만방로삼여적순향형AVRT 1례,만만형방실결절반성심동과속(AVNRT)1례,좌측유리벽방로삼여적순향형AVRT 2례.7례환자적량충심동과속균성공소융,소유환자소융술후수방2년,무일례VT혹SVT복발.결론 VT합병SVT병불소견,소융술중응방치필수적심강내전겁도관,완성상세전생리검사,피면루진.일차소융응근제량충질병.
Objective To evaluate effects of radiofrequency ablation of coexisting ventricular tachycardia(VT)and supraventricular tachycardia(SVT)in patients.Methods Seven patients[6 male,1 female,mean age(21±9)years old]with paroxysmal tachycardia for(3.7±2.0)years were included.All the 7 patients underwent electrophysiological study for induction of VT and SVT and radiofrequency ablation.Results Coexisting VT and SVT in 7 patients were easily reproducibly induced and terminated by atrial or ventricular stimulation.One patient with post-operation of correction of tetra logy fallout had coexisting right ventricular tachycardia and cavotricuspid isthmus-dependent flutter.The remaining 6 patients were all verapamil-sensitive idiopathic left ventricular tachycardia(ILVT)with coexisting AFL in 1 patient,orthodromic atrioventricular reentrant tachycardia(AVRT)in 4 (1 patient with a left posterior accessory pathway,1 patient with slow conduction accessory pathway in the ostium of coronary sinus.and 2 patients with accessory pathway in left free-wall)and slow-slow atrioventricular nodal reentrant tachycardia(AVNRT)in 1.All the tachycardias in 7patients were successfully ablated.All 7 patients were free from VT and SVT during 2 years follow-up.Conclusion Coexisting VT and SVT is not rare and two tachycardias must be all ablated in one procedure.Catheters inserted into heart cavity and detailed electrophysiological study are necessary.