Bilateral cardiac sympathetic denervation for refractory arrhythmia in an individual with catecholaminergic polymorphic ventricular tachycardia associated with T-cell-mediated ganglionitis.
Bilateral cardiac sympathetic denervation for refractory arrhythmia in an individual with catecholaminergic polymorphic ventricular tachycardia associated with T-cell-mediated ganglionitis.
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双侧心脏去交感神经支配治疗与 T 细胞介导的神经节炎相关的儿茶酚胺能多形性室性心动过速患者的难治性心律失常。
DOI：
10.1136/bcr-2021-244710
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发表时间：
2022
期刊：
影响因子：
0.9
通讯作者：
Carpenter A
中科院分区：
文献类型：
--
作者：
Carpenter A
在我们的病例中，个体在ryr2突变阳性儿茶酚胺能多态性室性心动过速（CPVT）的情况下难以控制心律失常，尽管药物治疗。由于室性心动过速（VT）和心室颤动（VF）以及快速发生的心房颤动（AF）导致的不适当的电击，反复发生植入式心律转复除颤器（ICD）电击。导管消融对控制房颤发作有效。尽管左心交感神经去支配，室性心律失常发作和随后的ICD休克持续存在。随后进行对侧交感心脏去神经支配，组织学提示t细胞介导的神经节炎。18个月后，没有再发生室性心律失常。
The individual in our case was troubled with difficult to control arrhythmia in the context of RYR2-mutation positive catecholaminergic polymorphic ventricular tachycardia (CPVT) despite medication. Recurrent implantable cardioverter defibrillator (ICD) shocks occurred for ventricular tachycardia (VT) and ventricular fibrillation (VF) as well as inappropriate shocks as a result of rapidly conducted atrial fibrillation (AF). Catheter ablation was effective in controlling these episodes of AF. Despite left cardiac sympathetic denervation, episodes of ventricular arrhythmia and subsequent ICD shocks persisted. Contralateral sympathetic cardiac denervation was subsequently undertaken, with histology suggesting T-cell mediated ganglionitis. 18 months on, there have been no further episodes of ventricular arrhythmia.