Wide QRS complex tachycardia with a mysterious mask-Tricuspid isthmus-dependent atrial flutter with preexcitation syndrome and dual atrioventricular nodal pathway conduction.
Wide QRS complex tachycardia with a mysterious mask-Tricuspid isthmus-dependent atrial flutter with preexcitation syndrome and dual atrioventricular nodal pathway conduction.
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DOI：
10.1002/ccr3.8202
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发表时间：
2023-11
影响因子：
0.7
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中科院分区：
文献类型：
--
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房扑和室上性心动过速是临床常见的心律失常。然而，一些AFL病例可能存在额外的复杂性，例如旁路（AP）和双房室结通路，戴上神秘的面具，使心电图（ECG）难以区分。一例60岁男性患者突发晕厥，ECG显示宽QRS波群心动过速。通过AP传导的SVT可以表现出类似于室性心动过速（VT）的宽QRS波群心动过速特征，这一事实进一步加剧了这种诊断模糊性。因此，通过电生理（EP）检查进行明确诊断变得势在必行，因为它决定了随后的消融策略。在这篇文章中，我们提出了一个罕见的情况下，涉及三种不同的心律失常，包括房扑，AP，和双房室结途径，并成功地通过消融治疗。消融靶点的三维标测。
Atrial flutter (AFL) and supraventricular tachycardia (SVT) are common arrhythmias in clinic. However, some AFL cases may present additional complexities, such as both accessory pathways (AP) and dual atrioventricular node pathways, putting on a mysterious mask and making it challenging to distinguish on electrocardiograms (ECGs). A 60‐year‐old male patient had a sudden syncope, and an ECG showed wide QRS complex tachycardia. This diagnostic ambiguity is further compounded by the fact that SVT via AP conduction can exhibit wide QRS complex tachycardia characteristics resembling ventricular tachycardia (VT). Consequently, a definitive diagnosis through electrophysiological (EP) examination becomes imperative, as it dictates subsequent ablation strategies. In this article, we present a rare case involving three distinct arrhythmias including AFL, AP, and dual atrioventricular node pathways, and successfully treated through ablation. Three‐dimensional mapping of ablation targets.