Successful Catheter Ablation of Hemodynamically Unstable Monomorphic Ventricular Tachycardia in a Patient with Hypertrophic Cardiomyopathy and Apical Aneurysm
Successful Catheter Ablation of Hemodynamically Unstable Monomorphic Ventricular Tachycardia in a Patient with Hypertrophic Cardiomyopathy and Apical Aneurysm
复制标题
成功导管消融肥厚型心肌病和心尖动脉瘤患者血流动力学不稳定的单形性室性心动过速
DOI：
10.1111/j.1540-8167.2008.01366.x
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
B. Knight
中科院分区：
文献类型：
--
作者：
Kiam;B. Maron;B. Knight
肥厚型心肌病（HCM）和左心室（LV）心尖部动脉瘤患者代表了这一异质性疾病谱中以前未被认识到但重要的亚组。心尖动脉瘤和心肌纤维化的邻近区域与单形性室性心动过速（VT）相关，并增加了包括心源性猝死在内的不良临床事件的风险，因此优先应用一级预防植入式心脏起搏器。然而，室性心动过速可能是重复性的，因此需要考虑其他治疗策略，如射频消融。在这份报告中，我们描述了这样一个患有肥厚型心肌病和心尖动脉瘤的患者，标测和消融术有效地识别和消除了室性心动过速病灶。
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular (LV) apical aneurysm represent a previously under‐recognized but important subgroup within this heterogeneous disease spectrum. Apical aneurysms and the contiguous areas of myocardial fibrosis have been associated with monomorphic ventricular tachycardia (VT) and increased risk for adverse clinical events including sudden cardiac death, prioritizing the application of primary prevention implantable defibrillators. However, VT may be repetitive, thereby raising considerations for additional treatment strategies such as radiofrequency ablation. In this report, we describe such a patient with HCM and apical aneurysm in whom the mapping and ablation procedure was effective in identifying and abolishing the VT focus.